Individual
DR. BARRY S RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
307 MAPLE AVE W, SUITE A, VIENNA, VA 22180-4307
(703) 281-7104
(703) 281-2175
Mailing address
307 MAPLE AVE W, SUITE A, VIENNA, VA 22180-4307
(703) 281-7104
(703) 281-2175
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005322
VA
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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