Individual
CODY RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2916 W STOLLEY PARK RD STE B, GRAND ISLAND, NE 68801-6808
(308) 382-6660
Mailing address
311 RENEE RD, DONIPHAN, NE 68832-9797
(308) 530-1876
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7641
NE
1223G0001X
General Practice Dentistry
Primary
7641
NE
Other
Enumeration date
07/14/2020
Last updated
07/21/2022
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