Provider Demographics
NPI:1083745921
Name:RUIZ, MARISOL (DMD)
Entity type:Individual
Prefix:DR
First Name:MARISOL
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 S RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-6518
Mailing Address - Country:US
Mailing Address - Phone:561-395-0550
Mailing Address - Fax:
Practice Address - Street 1:7280 W PALMETTO PARK RD STE 206N
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3412
Practice Address - Country:US
Practice Address - Phone:561-395-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN125441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice