Provider Demographics
NPI:1528000916
Name:BUDLONG, RHONDA J (DDS)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:J
Last Name:BUDLONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 MAIN AVE S
Mailing Address - Street 2:PO BOX 352
Mailing Address - City:BRITT
Mailing Address - State:IA
Mailing Address - Zip Code:50423
Mailing Address - Country:US
Mailing Address - Phone:641-843-3827
Mailing Address - Fax:641-843-3380
Practice Address - Street 1:311 MAIN AVE S
Practice Address - Street 2:
Practice Address - City:BRITT
Practice Address - State:IA
Practice Address - Zip Code:50423
Practice Address - Country:US
Practice Address - Phone:641-843-3827
Practice Address - Fax:641-843-3380
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1047415Medicaid