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Organization
SEACREST DENTAL II LLC
Active
Organization
SEACREST DENTAL II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED EDWIN RUDER DDS (CO-OWNER)
(850) 231-3736
Entity
Organization
Contact information
Practice address
66 N HOLIDAY RD, MIRAMAR BEACH, FL 32550-6936
(850) 231-3736
(888) 654-4326
Mailing address
5399 E COUNTY HIGHWAY 30A, SUITE 1, SANTA ROSA BEACH, FL 32459-6717
(850) 231-3736
(888) 654-4326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN10145
FL
Other
Enumeration date
07/30/2013
Last updated
05/21/2014
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