Provider Demographics
NPI:1659450591
Name:RUDD, ANDREW LEE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LEE
Last Name:RUDD
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:891 WILLOW DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7077
Mailing Address - Country:US
Mailing Address - Phone:919-932-1616
Mailing Address - Fax:919-932-1615
Practice Address - Street 1:891 WILLOW DR
Practice Address - Street 2:SUITE 4
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7077
Practice Address - Country:US
Practice Address - Phone:919-932-1616
Practice Address - Fax:919-932-1615
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC74801223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics