Provider Demographics
NPI:1861736084
Name:RUGGIERO, JULIE C (RDH)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:C
Last Name:RUGGIERO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2111
Mailing Address - Country:US
Mailing Address - Phone:585-325-5260
Mailing Address - Fax:585-325-3017
Practice Address - Street 1:417 SOUTH AVE
Practice Address - Street 2:ST.JOSEPH NEIGHBORHOOD CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-325-5260
Practice Address - Fax:585-325-3019
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011904-1124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist