Provider Demographics
NPI:1871035725
Name:RUMINSKI, DENISE (RDH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RUMINSKI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:HALLIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:5 LENAPE COURT
Mailing Address - Street 2:APT B
Mailing Address - City:WILKES-BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-881-7732
Mailing Address - Fax:
Practice Address - Street 1:103 MAIN ST
Practice Address - Street 2:
Practice Address - City:LUZERNE
Practice Address - State:PA
Practice Address - Zip Code:18709-1209
Practice Address - Country:US
Practice Address - Phone:570-288-2393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH011664L124Q00000X
PADHA002197124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist