Mary Rasty, DDS Valid NPI

Individual provider · General Practice Dentistry · Waukegan, IL

NPI

1437132412

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

019025325 (IL)

Sex

Female

Sole proprietor

No

Enumerated

2005-11-23

Last updated

2008-12-19