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General NPI Number Information
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NPI Number | 1639232705
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Entity Type | Individual
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Provider Name | NIMSY RUIZ D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | CAROLINA SHOPP CTR STE 311 AVE 65TH INF ESQ ROBERTO CLEMENTE
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City | CAROLINA
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State | PR
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Zip | 00985-5672
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Country | US
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Telephone | 787-512-0488
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Fax | 787-752-0332
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Provider Business Mailing Address
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Address Line | LAS HACIENDAS 15043 CALLE CAMINO LARGO
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-438-2186
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2669
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License Number State | PR
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