Provider Demographics
NPI:1730285230
Name:RUDMAN, ROBERT T (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:T
Last Name:RUDMAN
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:4500 CHERRY CREEK DRIVE SOUTH
Mailing Address - Street 2:850
Mailing Address - City:GLENDALE
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5330
Mailing Address - Country:US
Mailing Address - Phone:303-331-0222
Mailing Address - Fax:303-370-0124
Practice Address - Street 1:4500 E CHERRY CREEK SOUTH DR
Practice Address - Street 2:850
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1518
Practice Address - Country:US
Practice Address - Phone:303-331-0222
Practice Address - Fax:303-370-0124
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2016-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO80251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841597197OtherTIN