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General NPI Number Information
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NPI Number | 1033909601
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Entity Type | Individual
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Provider Name | HANNAH CZARINA RUSTIA DMD
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Gender | Female
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 12/07/2025
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Provider Practice Location Address
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Address Line | 7855 ARGYLE FOREST BLVD STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32244-5597
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Country | US
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Telephone | 904-777-3308
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Fax |
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Provider Business Mailing Address
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Address Line | 281 CROSS RIDGE DR
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City | PONTE VEDRA
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State | FL
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Zip | 32081-8445
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Country | US
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Telephone | 732-245-3623
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30776
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License Number State | FL
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