Provider Demographics
NPI:1174562284
Name:RICE, ANN RUTLEDGE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:RUTLEDGE
Last Name:RICE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:RUTLEDGE
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:611 LONGMIRE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1818
Mailing Address - Country:US
Mailing Address - Phone:936-756-3022
Mailing Address - Fax:
Practice Address - Street 1:611 LONGMIRE RD
Practice Address - Street 2:SUITE B
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1818
Practice Address - Country:US
Practice Address - Phone:936-756-3022
Practice Address - Fax:936-442-2006
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice