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Individual

DR. MITCHELL G RUDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1955 S 1300 E STE 6, SALT LAKE CITY, UT 84105-3684
(801) 487-0758
(801) 487-0750
Mailing address
1955 S 1300 E STE 6, SALT LAKE CITY, UT 84105-3684
(801) 487-0758
(801) 487-0750

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5328713-9922
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01595375
UNITED CONCORDIA NUMBER
UT
Enumeration date
10/02/2006
Last updated
09/19/2008
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