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Organization
RUCKMAN ORAL SURGERY & IMPLANT CENTER
Active
Organization
RUCKMAN ORAL SURGERY & IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELLE WISSMAN (OFFICE MANAGER)
(260) 489-0001
Entity
Organization
Contact information
Practice address
9901 AUBURN RD, FORT WAYNE, IN 46825-2345
(260) 489-0001
(260) 489-0004
Mailing address
9901 AUBURN RD, FORT WAYNE, IN 46825-2345
(260) 489-0001
(260) 489-0004
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
12/28/2016
Last updated
02/22/2022
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