# KEVIN D RUCINSKI DDS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Roscommon Family Dentistry Michigan Denture Assoc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427260009
- **Authorized official:** MR. KEVIN BRIAN RUCINSKI DDS (OWNER PRESIDENT)
- **Authorized official phone:** (989) 821-9222

## Contact information

- **Practice address:** 188 PINE BLUFFS, ROSCOMMON, MI 48653
- **Practice address phone:** (989) 821-9222
- **Practice address fax:** (989) 821-4981
- **Mailing address:** 188 PINE BLUFFS, ROSCOMMON, MI 48653
- **Mailing address phone:** (989) 821-9222
- **Mailing address fax:** (989) 821-4981

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 14132 | MI | Yes |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4529944 | — | MI |