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Individual

DR. KEITH L. RUDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
140 SHERMAN ST, FAIRFIELD, CT 06824-5849
(203) 254-9533
Mailing address
140 SHERMAN ST, FAIRFIELD, CT 06824-5849
(203) 254-9533

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
006950
CT

Other

Enumeration date
04/29/2008
Last updated
04/29/2008
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