Provider Demographics
NPI:1639749146
Name:RUZO, ANA LUCIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANA
Middle Name:LUCIA
Last Name:RUZO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7139 HILLGREEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-1933
Mailing Address - Country:US
Mailing Address - Phone:214-629-2651
Mailing Address - Fax:
Practice Address - Street 1:6650 S VINE ST STE L-20
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-2773
Practice Address - Country:US
Practice Address - Phone:303-795-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO205318122300000X
OK7476122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty