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General NPI Number Information
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NPI Number | 1740391648
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Entity Type | Individual
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Provider Name | MICHELLE NANESE RUIZ DDS
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/21/2015
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Provider Practice Location Address
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Address Line | 1600 S COULTER ST BLDG G, SUITE 500
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City | AMARILLO
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State | TX
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Zip | 79106-1710
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Country | US
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Telephone | 806-351-2762
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Fax | 806-351-2763
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Provider Business Mailing Address
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Address Line | 2017 WESTWOOD DR
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City | AMARILLO
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State | TX
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Zip | 79124-1330
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Country | US
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Telephone | 806-373-5751
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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 | 17910
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License Number State | TX
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