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General NPI Number Information
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NPI Number | 1861549446
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Entity Type | Individual
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Provider Name | RALPH T. RUCINSKI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 950 S COURT ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4848
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Country | US
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Telephone | 219-662-3855
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Fax |
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Provider Business Mailing Address
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Address Line | 12780 CLARK ST
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City | CROWN POINT
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State | IN
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Zip | 46307-8749
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Country | US
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Telephone | 219-663-2694
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 6848
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License Number State | IN
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