# RONALD L RUMBAUGH DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578959375
- **Authorized official:** DR. RONALD LEE RUMBAUGH DDS (PRESIDENT)
- **Authorized official phone:** (260) 637-6976

## Contact information

- **Practice address:** 10506 COLDWATER RD, FORT WAYNE, IN 46845-1235
- **Practice address phone:** (260) 637-6976
- **Practice address fax:** (260) 637-6976
- **Mailing address:** 10506 COLDWATER RD, FORT WAYNE, IN 46845-1235
- **Mailing address phone:** (260) 637-6976
- **Mailing address fax:** (260) 637-6976

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12008140A | IN | Yes |

## Other

- **Enumeration date:** 04/09/2015
- **Last updated:** 04/09/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100055440A | — | IN |