National Provider Identifier

Kathleen Marie Rusnak

Kathleen Marie Rusnak is listed in the NPPES registry with a primary specialty of Pediatric Dentistry in Orchard Park, NY and a listed phone number of (716) 332-2444.

NPI 1265061329Orchard Park, NYPediatric Dentistry

Profile Overview

NPI
1265061329
Provider Type
Individual
Primary Specialty
Pediatric Dentistry
Enumeration Date
April 02, 2020
Last Updated
December 16, 2022

Practice Location

  • 3364 Southwestern Blvd
  • Orchard Park, NY 14127-1524

Phone: (716) 332-2444

Mailing Address

  • 13991 Route 78
  • South Wales, NY 14139-9519

Specialties

  • Pediatric Dentistry (1223P0221X)
Full Record
NPI
1265061329
Entity Type
Individual
Last Name
Rusnak
First Name
Kathleen
Middle Name
Marie
Mailing Street Address
13991 Route 78
Mailing City
South Wales
Mailing State
NY
Mailing ZIP Code
14139-9519
Mailing Country
US
Practice Street Address
3364 Southwestern Blvd
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127-1524
Practice Country
US
Practice Phone
(716) 332-2444
Enumeration Date
April 02, 2020
Last Updated
December 16, 2022
Sex
Female
Sole Proprietor
No
Certification Date
December 16, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Pediatric Dentistry (1223P0221X)