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General NPI Number Information
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NPI Number | 1134694573
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Entity Type | Organization
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Legal Business Name | KENNETH J. RUDMAN, D.M.D.
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Dates
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Enumeration Date | 10/12/2018
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Last Update Date | 10/12/2018
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Provider Practice Location Address
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Address Line | 35 VETERANS MEMORIAL DR
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City | WARWICK
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State | RI
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Zip | 02886-4617
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Country | US
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Telephone | 401-737-5449
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Fax | 401-732-3695
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Provider Business Mailing Address
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Address Line | 35 VETERANS MEMORIAL DR
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City | WARWICK
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State | RI
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Zip | 02886-4617
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Country | US
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Telephone | 401-737-5449
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Fax | 401-732-3695
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH RUDMAN
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Credential | D.M.D
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Telephone | 401-737-5449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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