Individual
STACEY RUDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
N8977 STRINGERS BRIDGE RD, EAST TROY, WI 53120-1912
(414) 305-8056
Mailing address
N8977 STRINGERS BRIDGE RD, EAST TROY, WI 53120-1912
(414) 305-8056
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1003864
WI
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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