Individual
DANA RUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 LABORATORY RD, SUITE 101, OAK RIDGE, TN 37830-6810
(865) 483-7851
Mailing address
107 WINDGATE PL, OAK RIDGE, TN 37830-8644
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9897
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821269507
—
TN
Enumeration date
06/25/2014
Last updated
08/22/2014
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