Provider Demographics
NPI:1093788721
Name:LANTELME, RUDOLPH L (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:L
Last Name:LANTELME
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BRANCH ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-1900
Mailing Address - Country:US
Mailing Address - Phone:978-687-3131
Mailing Address - Fax:978-687-7009
Practice Address - Street 1:13 BRANCH ST
Practice Address - Street 2:SUITE 16
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-1900
Practice Address - Country:US
Practice Address - Phone:978-687-3131
Practice Address - Fax:978-687-7009
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133371223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics