Individual
DR. EVAN LEE RURAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1305 RODMAN AVE, PORTSMOUTH, VA 23707-3916
(757) 397-3296
Mailing address
1305 RODMAN AVE, PORTSMOUTH, VA 23707-3916
(757) 397-3296
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416089
VA
122300000X
Dentist
9838416-9921
UT
Other
Enumeration date
08/28/2016
Last updated
08/10/2021
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