| NPI | 1699800060 |
|---|---|
| Other Name | RUSTY RILEY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 7171) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MS 2570-90) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2021-05-05 |