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General NPI Number Information
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NPI Number | 1760182232
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Entity Type | Organization
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Legal Business Name | RONALD CRUZ ABARO DDS PC
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 03/03/2023
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Provider Practice Location Address
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Address Line | 514 E IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-2660
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Country | US
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Telephone | 574-291-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 514 E IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-2660
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Country | US
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Telephone | 574-291-6020
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MR. RONALD C ABARO
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Credential | DDS
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Telephone | 574-221-8841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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