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Individual

DR. ROBERT LEE RUIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1545 BUSINESS ONE CIR, WALLA WALLA, WA 99362-9526
(509) 525-4662
Mailing address
1545 BUSINESS ONE CIR, WALLA WALLA, WA 99362-9526
(509) 525-4662

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00008999
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
428495442760
PREMERA BLUE CROSS
WA
05
5050976
WA
Enumeration date
03/08/2007
Last updated
06/26/2014
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