| Dirk Russell D.m.d., P.c. | |
|
8014 Cumming Hwy Suite 401 Canton GA 30115-9339 | |
| (770) 345-2010 | |
| (770) 345-0571 |
| Full Name | Dirk Russell D.m.d., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8014 Cumming Hwy, Canton, Georgia |
| Authorized Official Name and Position | Dirk Russell (OWNER) |
| Authorized Official Contact | 7703452010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dirk Russell D.m.d., P.c. 8014 Cumming Hwy Suite 401 Canton GA 30115-9339 Ph: (770) 345-2010 | Dirk Russell D.m.d., P.c. 8014 Cumming Hwy Suite 401 Canton GA 30115-9339 Ph: (770) 345-2010 |
| NPI Number | 1689754202 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 08/28/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689754202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN012158 (Kentucky) | Primary |
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