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General NPI Number Information
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NPI Number | 1568857977
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Entity Type | Individual
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Provider Name | MARIE RUSCH RDH
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Gender | Female
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 25 NASHUA RD UNIT D3
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City | LONDONDERRY
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State | NH
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Zip | 03053-3446
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Country | US
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Telephone | 603-432-6430
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Fax |
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Provider Business Mailing Address
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Address Line | 1023 SHIRLEY AVE
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City | GOFFSTOWN
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State | NH
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Zip | 03045-1816
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Country | US
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Telephone |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 02501
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License Number State | NH
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