Provider Demographics
NPI:1568460095
Name:RUDD, ARTHUR L (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:L
Last Name:RUDD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 N LIDGERWOOD ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1122
Mailing Address - Country:US
Mailing Address - Phone:509-489-2538
Mailing Address - Fax:509-487-7197
Practice Address - Street 1:5901 N LIDGERWOOD ST
Practice Address - Street 2:SUITE 225
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1122
Practice Address - Country:US
Practice Address - Phone:509-489-2538
Practice Address - Fax:509-487-7197
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000038531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA03489OtherDELTA DENTAL
WA29346RUOtherLABOR AND INDUSTRIES
WA5348909Medicaid