Organization
BLACK & RUIZ DENTAL CENTRE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE NANESE RUIZ DDS (PRESIDENT/DENTIST)
(806) 351-2762
Entity
Organization
Contact information
Practice address
1600 S COULTER ST, BLDG B SUITE 208, AMARILLO, TX 79106-1710
(806) 351-2762
(806) 351-2763
Mailing address
1600 S COULTER ST, BLDG B SUITE 208, AMARILLO, TX 79106-1710
(806) 351-2762
(806) 351-2763
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17910,20035,13861
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G60131-01
CHIPS
TX
Enumeration date
01/15/2008
Last updated
01/15/2008
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