Provider Demographics
NPI:1598102675
Name:RUANE, ALLEN SNYDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:SNYDER
Last Name:RUANE
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 1:3159 RAWLE ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2618
Mailing Address - Country:US
Mailing Address - Phone:215-333-1770
Mailing Address - Fax:
Practice Address - Street 1:3159 RAWLE ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-2618
Practice Address - Country:US
Practice Address - Phone:215-333-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022340L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA124914OtherBC/BC