Individual
DR. REBECCA HAVEL PRUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1223 LAKE STREET, ALGOMA, WI 54201
(920) 487-5648
(920) 487-5658
Mailing address
1223 LAKE STREET, ALGOMA, WI 54201
(920) 469-1167
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5658-015
WI
Other
Enumeration date
03/05/2007
Last updated
04/01/2016
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