Provider Demographics
NPI:1386174464
Name:RUST, AMY E (DMD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:RUST
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:341 RATTLESNAKE HILL RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NH
Mailing Address - Zip Code:03032-3733
Mailing Address - Country:US
Mailing Address - Phone:603-818-1857
Mailing Address - Fax:
Practice Address - Street 1:345 VILLAGE ST
Practice Address - Street 2:
Practice Address - City:PENACOOK
Practice Address - State:NH
Practice Address - Zip Code:03303-4516
Practice Address - Country:US
Practice Address - Phone:603-753-6371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice