Provider Demographics
NPI:1386299766
Name:BENJAMIN RUDOW DDS PC
Entity type:Organization
Organization Name:BENJAMIN RUDOW DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-949-8266
Mailing Address - Street 1:280 MAMARONECK AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1460
Mailing Address - Country:US
Mailing Address - Phone:914-949-8266
Mailing Address - Fax:
Practice Address - Street 1:280 MAMARONECK AVE STE 307
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1460
Practice Address - Country:US
Practice Address - Phone:914-949-8266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-02
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty