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General NPI Number Information
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NPI Number | 1164862553
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Entity Type | Individual
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Provider Name | AARON R RUCKER DMD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2013
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 233 EAST MAIN STREET
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-756-8686
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Fax | 801-765-5651
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Provider Business Mailing Address
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Address Line | 233 EAST MAIN STREET
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City | AMERICAN FORK
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State | UT
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Zip | 84003
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Country | US
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Telephone | 801-756-8686
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Fax | 801-763-5651
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019029495
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13490263-8903
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13490263-9923
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License Number State | UT
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