| Edmund R. Rudnicke Ii, Prof Corp | |
|
302 E Lincoln St Joseph IL 61873 | |
| (217) 469-2202 | |
| (217) 469-2213 |
| Full Name | Edmund R. Rudnicke Ii, Prof Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 302 E Lincoln, St Joseph, Illinois |
| Authorized Official Name and Position | Edmund R Rudnicke (PRESIDENT) |
| Authorized Official Contact | 2174692202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edmund R. Rudnicke Ii, Prof Corp 302 E Lincoln Po Box 678 Saint Joseph IL 61873 Ph: (217) 469-2202 | Edmund R. Rudnicke Ii, Prof Corp 302 E Lincoln St Joseph IL 61873 Ph: (217) 469-2202 |
| NPI Number | 1750484036 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750484036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |