Jeremy I Rudd, D.M.D. Valid NPI
Individual provider · General Practice Dentistry · Mansfield, TX
- NPI
- 1073602645
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 22486 (TX)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-10-12
- Last updated
- 2009-05-26
Practice location
1750 E Broad St
Mansfield, TX 76063-3400
(817) 473-6857