Provider Demographics
NPI:1063634269
Name:RUDEN, RICHARD DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAVID
Last Name:RUDEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 JESSUP RD
Mailing Address - Street 2:SUITE 805
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08086
Mailing Address - Country:US
Mailing Address - Phone:856-845-3299
Mailing Address - Fax:856-848-8587
Practice Address - Street 1:800 JESSUP RD
Practice Address - Street 2:SUITE 805
Practice Address - City:WEST DEPTFORD
Practice Address - State:NJ
Practice Address - Zip Code:08086
Practice Address - Country:US
Practice Address - Phone:856-845-3299
Practice Address - Fax:856-848-8587
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ143011223G0001X
NJ22DIO14301001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice