Provider Demographics
NPI:1518155506
Name:RUYL, JAMES PETER (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PETER
Last Name:RUYL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 LABORATORY RD
Mailing Address - Street 2:SUITE # 105
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6810
Mailing Address - Country:US
Mailing Address - Phone:865-482-2546
Mailing Address - Fax:
Practice Address - Street 1:400 LABORATORY RD
Practice Address - Street 2:SUITE # 105
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6810
Practice Address - Country:US
Practice Address - Phone:865-482-2546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS1897122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist