Provider Demographics
NPI:1710997937
Name:HYDUK, RODNEY DAVID (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DAVID
Last Name:HYDUK
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 W SQUARE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2975
Mailing Address - Country:US
Mailing Address - Phone:248-879-6200
Mailing Address - Fax:248-879-7859
Practice Address - Street 1:90 W SQUARE LAKE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2975
Practice Address - Country:US
Practice Address - Phone:248-879-6200
Practice Address - Fax:248-879-7859
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MID107991223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics