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1174675185
KENNETH BRIAN RUSANOWSKI
SANTA FE, NM
NPI
1174675185
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0300X Dentist, Periodontics
(Licence: NM DD1585)
Enumeration Date
2007-01-18
Last Update Date
2007-07-08
Business Address
Mr. KENNETH BRIAN RUSANOWSKI DDS
2 CALLE MEDICO STE 2
SANTA FE, NM 87505
Phone number: 505-988-2611
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Mailing Address
Mr. KENNETH BRIAN RUSANOWSKI DDS
2 CALLE MEDICO STE 2
SANTA FE, NM 87505
Phone number: 505-988-2611
Copy
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