Provider Demographics
NPI:1992704795
Name:RUSH, STEVEN MATTHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MATTHEW
Last Name:RUSH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 S HAVANA ST
Mailing Address - Street 2:#200
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4018
Mailing Address - Country:US
Mailing Address - Phone:303-755-8388
Mailing Address - Fax:303-755-0986
Practice Address - Street 1:1450 S HAVANA ST
Practice Address - Street 2:#200
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4018
Practice Address - Country:US
Practice Address - Phone:303-755-8388
Practice Address - Fax:303-755-0986
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1066311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice