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Individual

DR. EDWARD TUCKER RUDISILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1030 N COLORADO ST, GILBERT, AZ 85233-2288
(501) 701-0539
Mailing address
1030 N COLORADO ST, GILBERT, AZ 85233-2288
(501) 701-0539

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
7215
LA
122300000X
Dentist
Primary
D011952
AZ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/06/2021
Last updated
10/06/2023
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