| Marjan Rusta DDS Inc | |
|
1313 Gilman St Ste A Berkeley CA 94706-2431 | |
| (510) 526-7546 | |
| Not Available |
| Full Name | Marjan Rusta DDS Inc |
|---|---|
| Speciality | Dentist |
| Location | 1313 Gilman St Ste A, Berkeley, California |
| Authorized Official Name and Position | Marjan Rusta (OWNER) |
| Authorized Official Contact | 5105267546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marjan Rusta DDS Inc 1313 Gilman St Ste A Berkeley CA 94706-2431 Ph: (510) 526-7546 | Marjan Rusta DDS Inc 1313 Gilman St Ste A Berkeley CA 94706-2431 Ph: (510) 526-7546 |
| NPI Number | 1164246864 |
|---|---|
| Provider Enumeration Date | 11/11/2024 |
| Last Update Date | 11/11/2024 |
| Certification Date | 11/11/2024 |
| Medicare PECOS PAC ID | 5395265565 |
|---|---|
| Medicare Enrollment ID | O20250219001444 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164246864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | () | Secondary |
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