MEDICARE: ROBERT S RUEHRWEIN DDS PC

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	042965	NY

General Provider Information

NPI Number	:	1679645667
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT S RUEHRWEIN DDS PC

Provider Business Mailing Address
First Line	:	5860 GOODRICH RD
Second Line	:	PO BOX 356
City	:	CLARENCE CENTER
State	:	NY
Zip	:	14032-0356
Country	:	US
Telephone Number	:	716-741-9774
Fax Number	:	716-741-4469

Provider Business Practice Location Address
First Line	:	5860 GOODRICH RD
Second Line	:
City	:	CLARENCE CENTER
State	:	NY
Zip	:	14032-0356
Country	:	US
Telephone Number	:	716-741-9774
Fax Number	:	716-741-4469

Authorized Official
Title or Position	:	CEO
Name	:	DR. ROBERT S RUEHRWEIN
Credential	:	DDS
Telephone Number	:	716-741-9774

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	09/30/2008

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