# DR. MARY LYNN RUTHERFORD YOUNGBAUER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447347869
- **Gender:** F
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1538 | MT | Yes |

## Other

- **Enumeration date:** 10/06/2006
- **Last updated:** 07/08/2007

## 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 |