Edward Rudolph

NPI #1457649824 in New Square, New York

Provider Information

NPI Number: 1457649824
Entity Type: Individual
Name: Edward Rudolph
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 19, 2011
Last Updated: Jul 17, 2012

Practice Location

Address: 728 N MAIN ST
City: New Square
State: New York
ZIP Code: 10977-8916
Phone: (845) 354-9300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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