Provider Demographics
NPI:1811033913
Name:RUIZ, CARLA VANESSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:VANESSA
Last Name:RUIZ
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 1:1535 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5878
Mailing Address - Country:US
Mailing Address - Phone:786-417-7295
Mailing Address - Fax:800-928-3811
Practice Address - Street 1:1535 SUNSET DR
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5878
Practice Address - Country:US
Practice Address - Phone:800-895-1570
Practice Address - Fax:800-928-3811
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN170561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry