THAD RUSIECKI DDS PLLC NPI 1992921092

NPI Information

THAD RUSIECKI, DDS, PLLC is an oral and maxillofacial surgery dentist in Morgantown, WV. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. THAD RUSIECKI, DDS, PLLC NPI is 1992921092. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2602 CRANBERRY SQUARE
MORGANTOWN, WV
ZIP 26505
Phone: (304) 594-1515
Fax: (304) 594-0785

The provider's authorized official is Thad Rusiecki .
The authorized official title is Owner and has the following contact phone number (304) 594-1515.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 9/15/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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