Provider Demographics
NPI:1356969216
Name:RUDSENSKE, CAITLIN ALFORD (DMD)
Entity type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:ALFORD
Last Name:RUDSENSKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:BRIANNA
Other - Last Name:ALFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 MASON ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:TN
Mailing Address - Zip Code:38337-3422
Mailing Address - Country:US
Mailing Address - Phone:225-287-0140
Mailing Address - Fax:
Practice Address - Street 1:113 KENNEDY DR
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-3344
Practice Address - Country:US
Practice Address - Phone:731-587-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11356122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist