Organization
ADVANTAGE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYNNA RUST RDH, EPDH (DENTAL HYGIENIST)
(541) 571-7605
Entity
Organization
Contact information
Practice address
2381 NE CONNERS AVE, BEND, OR 97701-6068
(888) 468-0022
Mailing address
948 NW 17TH ST, REDMOND, OR 97756-1353
(541) 571-7605
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
H6967
OR
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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