Provider Demographics
NPI:1093359226
Name:RUDDOCKS, LAUREN ANNE (BDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ANNE
Last Name:RUDDOCKS
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:UF COLLEGE OF DENTISTRY 1395 CENTER DRIVE RM D8-12
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0001
Mailing Address - Country:US
Mailing Address - Phone:352-273-6683
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF FLORIDA COLLEGE OF DENTISTRY
Practice Address - Street 2:1395 CENTER DRIVE
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610
Practice Address - Country:US
Practice Address - Phone:352-273-6683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM20911223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology