Organization
RONALD L RUMBAUGH DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD LEE RUMBAUGH DDS (PRESIDENT)
(260) 637-6976
Entity
Organization
Contact information
Practice address
10506 COLDWATER RD, FORT WAYNE, IN 46845-1235
(260) 637-6976
(260) 637-6976
Mailing address
10506 COLDWATER RD, FORT WAYNE, IN 46845-1235
(260) 637-6976
(260) 637-6976
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12008140A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100055440A
—
IN
Enumeration date
04/09/2015
Last updated
04/09/2015
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