Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 13337 | MA |
NPI | 1093788721 |
---|---|
Provider Name | Dr. Rudolph L Lantelme |
First Address | Methuen, MA 01844-1900 |
Second Address | Methuen, MA 01844-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 08/07/2007 |