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Individual
DR. MARY LYNN RUTHERFORD YOUNGBAUER
Active
Individual
DR. MARY LYNN RUTHERFORD YOUNGBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1538
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0138008
—
MT
01
—
15384
BLUE CROSS
MT
01
—
5511779
STATE OF MT
MT
01
—
8331
STATE BOARD MN
MN
Enumeration date
10/06/2006
Last updated
07/08/2007
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