Provider Demographics
NPI:1831350586
Name:YOUNGQUIST, RUTH A (DDS)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:A
Last Name:YOUNGQUIST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4017
Mailing Address - Country:US
Mailing Address - Phone:405-707-0600
Mailing Address - Fax:405-707-0602
Practice Address - Street 1:8101 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-5059
Practice Address - Country:US
Practice Address - Phone:216-229-2500
Practice Address - Fax:216-229-2501
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190263931223G0001X
OH300229141223G0001X
TX236361223G0001X
AR37481223G0001X
OK61661223G0001X
LA60461223G0001X
IA087051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice