Healthcare Provider Details

I. General information

NPI: 1235343625
Provider Name (Legal Business Name): CHRIS S RUGGIERO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16360 PEARL ROAD
STRONGSVILLE OH
44136
US

IV. Provider business mailing address

16360 PEARL ROAD
STRONGSVILLE OH
44136
US

V. Phone/Fax

Practice location:
  • Phone: 440-238-2298
  • Fax: 440-846-4700
Mailing address:
  • Phone: 440-238-2298
  • Fax: 440-846-4700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30021072
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: