MEDICARE: DR. ROBERT T RUDMAN DDS MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	8025	CO

General Provider Information

NPI Number	:	1730285230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT T RUDMAN DDS MS

Provider Business Mailing Address
First Line	:	4500 CHERRY CREEK DRIVE SOUTH
Second Line	:	850
City	:	GLENDALE
State	:	CO
Zip	:	80206-5330
Country	:	US
Telephone Number	:	303-331-0222
Fax Number	:	303-370-0124

Provider Business Practice Location Address
First Line	:	4500 E CHERRY CREEK SOUTH DR
Second Line	:	850
City	:	GLENDALE
State	:	CO
Zip	:	80246-1518
Country	:	US
Telephone Number	:	303-331-0222
Fax Number	:	303-370-0124

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	01/27/2016

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