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Individual

DR. ERIC WILLIAM RUCKERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
880 WESTFALL RD, ROCHESTER, NY 14618-2611
(585) 473-1700
(585) 271-0806
Mailing address
880 WESTFALL RD, ROCHESTER, NY 14618-2611
(585) 473-1700
(585) 271-0806

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
034499
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00855078
NY
01
102051AT
PREFERRED CARE
NY
01
5448185
AETNA ID NUMBER
NY
01
7877ER
EXCELLUS
NY
01
P010034499
BLUE CHOICE ID
NY
Enumeration date
07/05/2006
Last updated
07/08/2007
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