| Dr Wyatt M Ruffin Jr | |
|
3940 Airline Blvd Chesapeake VA 23321-3329 | |
| (757) 465-4884 | |
| (757) 465-4884 |
| Full Name | Dr Wyatt M Ruffin Jr |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3940 Airline Blvd, Chesapeake, Virginia |
| Authorized Official Name and Position | Wyatt M Ruffin (OWNER PRESIDENT) |
| Authorized Official Contact | 7574654884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wyatt M Ruffin Jr 3940 Airline Blvd Suite 114 Chesapeake VA 23321-3329 Ph: (757) 465-4884 | Dr Wyatt M Ruffin Jr 3940 Airline Blvd Chesapeake VA 23321-3329 Ph: (757) 465-4884 |
| NPI Number | 1720159437 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720159437 | NPI | - | NPPES |
| 7821743 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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