# RYAN T. PRUITT, D.M.D & ASSOCIATES P.A.

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

## Provider details

- **NPI number:** 1821727520
- **Authorized official:** RYAN T PRUITT DMD (OWNER)
- **Authorized official phone:** (252) 756-3313

## Contact information

- **Practice address:** 2446 EMERALD PL, GREENVILLE, NC 27834-5784
- **Practice address phone:** (252) 756-3313
- **Practice address fax:** (252) 756-0146
- **Mailing address:** 2446 EMERALD PL, GREENVILLE, NC 27834-5784
- **Mailing address phone:** (252) 756-3313
- **Mailing address fax:** (252) 756-0146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 06/08/2022
- **Last updated:** 06/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1487832960 | LLC | NC |