Kenneth Brian Rusanowski DDS

NPI 1174675185 - Dentist - 1223P0300X

NPI Details
NPI 1174675185
Gender Male
Enumeration Date 01/18/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2 CALLE MEDICO
STE 2
SANTA FE NM, 87505, US
Phone (505) 988-2611
Fax (505) 820-0397
Business Location
2 CALLE MEDICO
STE 2
SANTA FE NM, 87505, US
Phone (505) 988-2611
Fax (505) 820-0397
Toxanomy
Taxonomy Code 1223P0300X
License State New Mexico
License Number DD1585
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According to our database, Mr. Kenneth Brian Rusanowski DDS NPI is 1174675185, taxonomy code is 1223P0300X and license number is DD1585, license state is located at New Mexico. Kenneth Brian Rusanowski DDS physically located at 2 Calle Medico, Santa Fe NM, 87505. NPI Number Kenneth Brian Rusanowski DDS has the Individual type.

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1174675185 NPI number is provided on an as is basis without warranty of any kind. 1174675185 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth Brian Rusanowski DDS are for informational purposes only.