Provider Demographics
NPI:1679645667
Name:ROBERT S RUEHRWEIN DDS PC
Entity Type:Organization
Organization Name:ROBERT S RUEHRWEIN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUEHRWEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:716-741-9774
Mailing Address - Street 1:5860 GOODRICH RD
Mailing Address - Street 2:PO BOX 356
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-0356
Mailing Address - Country:US
Mailing Address - Phone:716-741-9774
Mailing Address - Fax:716-741-4469
Practice Address - Street 1:5860 GOODRICH RD
Practice Address - Street 2:
Practice Address - City:CLARENCE CENTER
Practice Address - State:NY
Practice Address - Zip Code:14032-0356
Practice Address - Country:US
Practice Address - Phone:716-741-9774
Practice Address - Fax:716-741-4469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042965122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty