Provider Demographics
NPI:1700578994
Name:UBLY FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:UBLY FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TANESS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGGLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-705-7455
Mailing Address - Street 1:2228 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UBLY
Mailing Address - State:MI
Mailing Address - Zip Code:48475-9566
Mailing Address - Country:US
Mailing Address - Phone:989-658-8581
Mailing Address - Fax:989-658-2311
Practice Address - Street 1:2228 E MAIN ST
Practice Address - Street 2:
Practice Address - City:UBLY
Practice Address - State:MI
Practice Address - Zip Code:48475-9566
Practice Address - Country:US
Practice Address - Phone:989-658-8581
Practice Address - Fax:989-658-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental