MEDICARE: DR. ARTHUR L RUDD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DE00003853	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03489	OTHER	WA	DELTA DENTAL
2	29346RU	OTHER	WA	LABOR AND INDUSTRIES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568460095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR L RUDD DDS

Provider Business Mailing Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	SUITE 225
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-489-2538
Fax Number	:	509-487-7197

Provider Business Practice Location Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	SUITE 225
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-489-2538
Fax Number	:	509-487-7197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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