Provider Demographics
NPI:1750567764
Name:RUSKIN, DANIELLE RENAY (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:RENAY
Last Name:RUSKIN
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 1:30426 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-8583
Mailing Address - Country:US
Mailing Address - Phone:248-446-0288
Mailing Address - Fax:248-446-5257
Practice Address - Street 1:30426 MILFORD RD
Practice Address - Street 2:
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-8583
Practice Address - Country:US
Practice Address - Phone:248-446-0288
Practice Address - Fax:248-446-5257
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010177101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice