Individual
DR. ROBERT A NUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
605 HILLCREST AVE, SUITE 130, OWATONNA, MN 55060-3680
(507) 451-0290
(507) 451-0291
Mailing address
605 HILLCREST AVE, SUITE 130, OWATONNA, MN 55060-3680
(507) 451-0290
(507) 451-0291
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D8803
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009974
DORAL
MN
01
—
1009471
PREFERRED ONE
MN
01
—
118128
UCARE MN
MN
01
—
35177NU
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/29/2006
Last updated
07/08/2007
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