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Individual

RUSTAM SHUKUROV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
1130 OLD YORK RD, ABINGTON, PA 19001-3710
(866) 993-2352
Mailing address
9128 OLD NEWTOWN RD APT C12, PHILADELPHIA, PA 19115-4922
(215) 921-1279

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041334
PA

Other

Enumeration date
06/28/2017
Last updated
06/28/2017
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