Healthcare Provider Details

I. General information

NPI: 1336140276
Provider Name (Legal Business Name): DENNIS P RUGGERIE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 15TH AVE S
GREAT FALLS MT
59405
US

IV. Provider business mailing address

3000 15TH AVE S
GREAT FALLS MT
59405-5240
US

V. Phone/Fax

Practice location:
  • Phone: 406-454-2171
  • Fax: 406-771-3021
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number6498
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: