Individual
RUEDIGER TILLMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5872 S 900 E, 202, SALT LAKE CITY, UT 84121-1676
(801) 281-8433
(801) 281-8455
Mailing address
5872 S 900 E, 202, SALT LAKE CITY, UT 84121-1676
(801) 281-8433
(801) 281-8455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
142274
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005762263
AETNA INSURANCE
KY
01
—
0196
ALTIUS/MONARCH INSURANCE
UT
01
—
14705
PUBLIC EMPLOYEES INSURAN
TX
Enumeration date
10/10/2006
Last updated
07/09/2007
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