Organization
MEGAN RUSTAD, DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGAN RUSTAD DDS (ENDODONTIST)
(310) 621-4399
Entity
Organization
Contact information
Practice address
1502 MONTANA AVE STE 205, SANTA MONICA, CA 90403-1873
(310) 621-4399
Mailing address
1502 MONTANA AVE STE 205, SANTA MONICA, CA 90403-1873
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
57250
CA
Other
Enumeration date
05/24/2015
Last updated
05/26/2015
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