MEDICARE: DR. MELISSA LEE RUFF D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	51852	CA

General Provider Information

NPI Number	:	1285627737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA LEE RUFF D.M.D

Provider Business Mailing Address
First Line	:	8767 CAMINITO ABRAZO
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1601
Country	:	US
Telephone Number	:	858-952-9482
Fax Number	:

Provider Business Practice Location Address
First Line	:	3802 CLAIREMONT MESA BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-2712
Country	:	US
Telephone Number	:	858-200-7308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	11/07/2019

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