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Individual

DR. MARYKATE RUSNAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
3600 MITCHELL DRIVE, SUITE 40, MOUNTAIN KIDS PEDIATRIC DENTISTRY, FORT COLLINS, CO 80525
(970) 224-3600
(970) 568-8577
Mailing address
3600 MITCHELL DRIVE, SUITE 40, MOUNTAIN KIDS PEDIATRIC DENTISTRY, FORT COLLINS, CO 80525
(970) 224-3600
(970) 568-8577

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12010669A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200826610
IN
Enumeration date
10/11/2006
Last updated
08/07/2012
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