MEDICARE: DR. NATALIA L. RUZ 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	1223G0001X	General Practice Dentistry	019022956	IL

General Provider Information

NPI Number	:	1891072146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATALIA L. RUZ DDS

Provider Business Mailing Address
First Line	:	2300 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3414
Country	:	US
Telephone Number	:	773-743-2544
Fax Number	:	773-743-2534

Provider Business Practice Location Address
First Line	:	2300 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3414
Country	:	US
Telephone Number	:	773-743-2544
Fax Number	:	773-743-2534

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

Provider Enumeration Date	:	11/14/2011
Last Update Date	:	11/14/2011

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