Individual
JOSEPH RUSTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
425 W LAFAYETTE ST, WINNFIELD, LA 71483-3463
(318) 302-3261
(318) 302-3266
Mailing address
PO BOX 1288, WINNFIELD, LA 71483-1288
(318) 648-0375
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6500
LA
1223G0001X
General Practice Dentistry
Primary
6500
LA
Other
Enumeration date
06/25/2014
Last updated
04/24/2023
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