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NPI Code Detail

MEDICARE: LIENA RUIZ DDS

MEDICARE:   LIENA  RUIZ  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
11223G0001XGeneral Practice Dentistry62820CA

General Provider Information

NPI Number : 1962835389
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIENA RUIZ DDS
Provider Business Mailing Address
First Line : 4157 MAINE AVE
Second Line :
City : BALDWIN PARK
State : CA
Zip : 91706-3309
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4157 MAINE AVE
Second Line :
City : BALDWIN PARK
State : CA
Zip : 91706-3309
Country : US
Telephone Number : 626-337-1506
Fax Number : 626-337-3573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2013
Last Update Date : 08/21/2013

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Directions to “ LIENA RUIZ DDS” Practice Location

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