Provider Demographics
NPI:1447080049
Name:RUDICK DENTAL MANAGEMENT LLC
Entity type:Organization
Organization Name:RUDICK DENTAL MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-757-5749
Mailing Address - Street 1:119 W 57TH ST STE 1420
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2450
Mailing Address - Country:US
Mailing Address - Phone:212-757-5749
Mailing Address - Fax:212-307-7309
Practice Address - Street 1:119 W 57TH ST STE 1420
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2450
Practice Address - Country:US
Practice Address - Phone:212-757-5749
Practice Address - Fax:212-307-7309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty