Healthcare Provider Details

I. General information

NPI: 1306454335
Provider Name (Legal Business Name): FRANK P RUFFINO III DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2020
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51333 MOUND RD
SHELBY TWP MI
48316-4344
US

IV. Provider business mailing address

51333 MOUND RD
SHELBY TWP MI
48316-4344
US

V. Phone/Fax

Practice location:
  • Phone: 586-799-4240
  • Fax:
Mailing address:
  • Phone: 586-799-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER DUFF
Title or Position: OFFICE MANAGER
Credential: RDH
Phone: 586-799-4240