Organization
CINCY PEDIATRIC DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARIE RUDOLPH D.M.D (PEDIATRIC DENTIST)
(513) 400-8551
Entity
Organization
Contact information
Practice address
7777 YANKEE RD, LIBERTY TOWNSHIP, OH 45044-3500
(937) 245-0390
Mailing address
1131 CRYER AVE, CINCINNATI, OH 45208
(513) 400-8551
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/09/2020
Last updated
02/27/2023
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