Provider Demographics
NPI:1760182232
Name:RONALD CRUZ ABARO DDS PC
Entity Type:Organization
Organization Name:RONALD CRUZ ABARO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:ABARO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:574-221-8841
Mailing Address - Street 1:514 E IRELAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-2660
Mailing Address - Country:US
Mailing Address - Phone:574-291-6020
Mailing Address - Fax:
Practice Address - Street 1:514 E IRELAND RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-2660
Practice Address - Country:US
Practice Address - Phone:574-291-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental