Provider Demographics
NPI:1750852117
Name:TERRY W. RUDNYK, D.D.S., P.C.
Entity Type:Organization
Organization Name:TERRY W. RUDNYK, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:RUDNYK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-860-1266
Mailing Address - Street 1:9751 N 90TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5082
Mailing Address - Country:US
Mailing Address - Phone:480-860-1266
Mailing Address - Fax:480-860-1381
Practice Address - Street 1:9751 N 90TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5082
Practice Address - Country:US
Practice Address - Phone:480-860-1266
Practice Address - Fax:480-860-1381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental