Individual
JORGE EDUARDO RUIZ LOURIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(888) 700-6623
Mailing address
330 W 39TH ST APT 22B, NEW YORK, NY 10018-1792
(917) 873-5050
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061645
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2019
Last updated
05/30/2023
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