| Dr Alan Russell Plc | |
|
2010 27th Ave S Minneapolis MN 55406-1108 | |
| (612) 336-8478 | |
| Not Available |
| Full Name | Dr Alan Russell Plc |
|---|---|
| Speciality | Dentist |
| Location | 2010 27th Ave S, Minneapolis, Minnesota |
| Authorized Official Name and Position | Kathy Hubred (DENTAL ASSISTANT) |
| Authorized Official Contact | 6123368478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Alan Russell Plc 2010 27th Ave S Minneapolis MN 55406-1108 Ph: (612) 336-8478 | Dr Alan Russell Plc 2010 27th Ave S Minneapolis MN 55406-1108 Ph: (612) 336-8478 |
| NPI Number | 1194997783 |
|---|---|
| Provider Enumeration Date | 03/24/2008 |
| Last Update Date | 06/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194997783 | NPI | - | NPPES |
| 160213600 | Medicaid | MN | |
| 13D69RU | Other | MN | BLUE CROSS BLUE SHIELD |
| 710609 | Other | MN | UNITED OF CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 09480 (Minnesota) | Primary |
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