Individual
CORY MACKENZIE RUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4350 E RAY RD STE 112, PHOENIX, AZ 85044-4705
(480) 893-7674
Mailing address
2553 E LINDA LN, GILBERT, AZ 85234-1305
(602) 300-1059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9934
AZ
1223G0001X
General Practice Dentistry
30205
TX
Other
Enumeration date
07/07/2014
Last updated
03/17/2018
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