Individual
DR. BRUCE ANTHONY KUDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1500 NORTHWAY DRIVE, ST CLOUD, MN 56303
(320) 253-7700
(320) 253-9271
Mailing address
PO BOX 1659, ST CLOUD, MN 56302
(320) 253-7700
(320) 253-9271
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9182
MN
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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