MEDICARE: CHRISTINA N RUHALA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901023221	MI
2	1223G0001X	General Practice Dentistry	13151	NC

General Provider Information

NPI Number	:	1700444114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA N RUHALA DDS

Provider Business Mailing Address
First Line	:	5216 WINDMERE CHASE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-7405
Country	:	US
Telephone Number	:	517-420-2712
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 EDWARDS MILL RD STE 103
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-5303
Country	:	US
Telephone Number	:	919-914-9607
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2019
Last Update Date	:	04/04/2023

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