Individual provider · NPI-1
Dr. David Richard Russell, DMD
Dentist · Millersburg, PA
NPI number1376551192
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1376551192
- Entity type
- Individual (NPI-1)
- Name
- Dr. David Richard Russell
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 4, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DS018472 | PA | Yes |
Practice location
660 Rising Sun RoadMillersburg, PA 17061
Phone 717-692-4847 · Fax 717-692-4848
Mailing address
660 Rising Sun RoadMillersburg, PA 17061
Phone 717-692-4847 · Fax 717-692-4848
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