Provider Demographics
NPI:1104983709
Name:RUEMPING, DALE R (DDS , MSD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:R
Last Name:RUEMPING
Suffix:
Gender:M
Credentials:DDS , MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12615 E MISSION AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1047
Mailing Address - Country:US
Mailing Address - Phone:509-926-1234
Mailing Address - Fax:509-926-1701
Practice Address - Street 1:12615 E MISSION AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1047
Practice Address - Country:US
Practice Address - Phone:509-926-1234
Practice Address - Fax:509-926-1701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA56761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5015516Medicaid