Provider Demographics
NPI:1639394190
Name:RUGGIRELLO, JOSEPH ANTHINY (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHINY
Last Name:RUGGIRELLO
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 1:51218 ROMEO PLANK RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-4129
Mailing Address - Country:US
Mailing Address - Phone:586-677-7944
Mailing Address - Fax:
Practice Address - Street 1:51218 ROMEO PLANK RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-4129
Practice Address - Country:US
Practice Address - Phone:586-677-7944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17005122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist