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Individual

RYAN MICHAEL RUDD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS MS

Contact information

Practice address
611 E 8TH ST, PORT ANGELES, WA 98362-6223
(909) 528-3331
Mailing address
1311 E 5TH ST, PORT ANGELES, WA 98362-4709
(909) 528-3331

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE 60293923
WA

Other

Enumeration date
07/17/2008
Last updated
11/15/2012
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