Healthcare Provider Details

I. General information

NPI: 1790526531
Provider Name (Legal Business Name): RUAA WAELY DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8270 N TELEGRAPH RD
DEARBORN HEIGHTS MI
48127-1435
US

IV. Provider business mailing address

8270 N TELEGRAPH RD
DEARBORN HEIGHTS MI
48127-1435
US

V. Phone/Fax

Practice location:
  • Phone: 734-421-4150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: RUAA WAELY
Title or Position: OWNER/DENTIST
Credential:
Phone: 734-241-4150