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Individual

DR. GRANT RUSSELL RUTHERFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
NAVAL HOSPITAL CAMP PENDLETON, 200 MERCY CIRCLE, OCEANSIDE, CA 92055
(760) 763-7242
Mailing address
1221 MOANA DR, SAN DIEGO, CA 92107-3910
(303) 513-1361

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
10238
CO
1223E0200X
Endodontics
Primary
108827
CA

Other

Enumeration date
08/24/2010
Last updated
01/31/2025
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