Provider Demographics
NPI:1831943059
Name:RUCO ORTHODONTICS LLC
Entity type:Organization
Organization Name:RUCO ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:GALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-967-0113
Mailing Address - Street 1:4103 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-1807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:739 PRESIDENT PL STE 210
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6846
Practice Address - Country:US
Practice Address - Phone:615-425-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty