MEDICARE: MS. RUTH ELLEN TUROFF RDH

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	124Q00000X	Dental Hygienist	7917	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7917	OTHER	CA	RDH LICENSE

General Provider Information

NPI Number	:	1619146511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RUTH ELLEN TUROFF RDH

Provider Business Mailing Address
First Line	:	1410 ROBINSON AVE APT 7
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-4536
Country	:	US
Telephone Number	:	619-269-3536
Fax Number	:

Provider Business Practice Location Address
First Line	:	3538 BOUGAINVILLE RD BLDG 506
Second Line	:	BRANCH DENTAL ANNEX , NAB CORONADO
City	:	SAN DIEGO
State	:	CA
Zip	:	92155-5491
Country	:	US
Telephone Number	:	619-437-2954
Fax Number	:

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

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	12/31/2008

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