Organization
J D RUCKER JR DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D RUCKER JR. DDS (OWNER PRESIDENT)
(803) 377-1157
Entity
Organization
Contact information
Practice address
145 CENTER STREET, CHESTER, SC 29704-2704
(803) 377-1157
(803) 385-6898
Mailing address
PO BOX 147, CHESTER, SC 29704-2704
(803) 377-1157
(803) 385-6898
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
Z1899
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9826
—
SC
Enumeration date
02/23/2007
Last updated
08/22/2020
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