MEDICARE: DR. PATRICK A RUFO DDS

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	122300000X	Dentist	DD5059	NM
2	1223G0001X	General Practice Dentistry	41302	CA

General Provider Information

NPI Number	:	1639368434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK A RUFO DDS

Provider Business Mailing Address
First Line	:	2222 FRANCISCO DR.
Second Line	:	#460
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762
Country	:	US
Telephone Number	:	916-933-3011
Fax Number	:	916-933-6011

Provider Business Practice Location Address
First Line	:	2222 FRANCISCO DR STE 460
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-3780
Country	:	US
Telephone Number	:	916-933-3011
Fax Number	:	916-933-6011

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

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	06/07/2022

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