NPI 1023476363

Pablo Martin Ruck Troncoso

Practitioner General Practice Dentistry Woodbridge, VA

Practice location

Address: 4379 Ridgewood Center Dr STE 102, Woodbridge, VA 22192-8323
Phone: (703) 680-7950
Mailing address: 15386 Gunsmith Ter, Woodbridge, VA 22191-3928

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 0401415725 (VA)

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Registry record

NPI: 1023476363
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Feb 2016
Record last updated: 24 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.