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General NPI Number Information
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NPI Number | 1831107812
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Entity Type | Organization
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Legal Business Name | ALLEN S RUANE DDS PC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3159 RAWLE ST GROUND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2618
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Country | US
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Telephone | 215-333-1770
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Fax |
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Provider Business Mailing Address
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Address Line | 3159 RAWLE ST GROUND FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19149-2618
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Country | US
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Telephone | 215-333-1770
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. ALLEN SNYDER RUANE JR.
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Credential | DDS
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Telephone | 215-333-1770
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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 | DS022340L
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License Number State | PA
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