Provider Demographics
NPI:1497310379
Name:RUTHER, MARK (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:RUTHER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11147 MONTGOMERY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2383
Mailing Address - Country:US
Mailing Address - Phone:513-489-5599
Mailing Address - Fax:
Practice Address - Street 1:11147 MONTGOMERY RD STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2383
Practice Address - Country:US
Practice Address - Phone:513-489-5599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0257531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice