Basic Information
| Provider Information | |||||||||
| NPI: | 1831350586 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUNGQUIST | ||||||||
| FirstName: | RUTH | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 W 6TH AVE | ||||||||
| Address2: | |||||||||
| City: | STILLWATER | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740744017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057070600 | ||||||||
| FaxNumber: | 4057070602 | ||||||||
| Practice Location | |||||||||
| Address1: | 8101 EUCLID AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441035059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2162292500 | ||||||||
| FaxNumber: | 2162292501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2008 | ||||||||
| LastUpdateDate: | 04/21/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 019026393 | IL | N | Dental Providers | Dentist | General Practice | 1223G0001X | 30022914 | OH | Y | Dental Providers | Dentist | General Practice | 1223G0001X | 23636 | TX | N | Dental Providers | Dentist | General Practice | 1223G0001X | 3748 | AR | N | Dental Providers | Dentist | General Practice | 1223G0001X | 6166 | OK | N | Dental Providers | Dentist | General Practice | 1223G0001X | 6046 | LA | N | Dental Providers | Dentist | General Practice | 1223G0001X | 08705 | IA | N | Dental Providers | Dentist | General Practice |
No ID Information.