MEDICARE: RUFFINO & WHITFORD COSMETIC & FAMILY DENTISTRY

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1467270033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUFFINO & WHITFORD COSMETIC & FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	51333 MOUND RD
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-4344
Country	:	US
Telephone Number	:	586-799-4240
Fax Number	:	586-991-7105

Provider Business Practice Location Address
First Line	:	51333 MOUND RD
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48316-4344
Country	:	US
Telephone Number	:	586-799-4240
Fax Number	:	586-991-7105

Authorized Official
Title or Position	:	MANAGER
Name	:	JENNIFER DUFF
Credential	:	RDH
Telephone Number	:	586-799-4240

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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