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General NPI Number Information
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NPI Number | 1376942912
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Entity Type | Organization
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Legal Business Name | RONALD J RAGULSKY D.D.S., L.L.C.
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 08/20/2014
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Provider Practice Location Address
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Address Line | 3939 SANDALWOOD LN
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City | PUEBLO
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State | CO
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Zip | 81005-2586
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Country | US
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Telephone | 719-564-7737
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Fax | 719-564-0373
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Provider Business Mailing Address
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Address Line | 3939 SANDALWOOD LN
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City | PUEBLO
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State | CO
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Zip | 81005-2586
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Country | US
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Telephone | 719-564-7737
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Fax | 719-564-0373
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RONALD J RAGULSKY
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Credential | D.D.S.
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Telephone | 719-564-7737
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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 | 04921
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License Number State | CO
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