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1013331339
BENJAMIN RUSSELL
PARK CITY, UT
NPI
1013331339
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: UT 5729440)
Enumeration Date
2014-02-06
Last Update Date
2014-02-06
Business Address
-- BENJAMIN RUSSELL D.D.S.
2700 HOMESTEAD RD #130
PARK CITY, UT 84098-4857
Phone number: 435-940-9900
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Mailing Address
-- BENJAMIN RUSSELL D.D.S.
2700 HOMESTEAD RD #130
PARK CITY, UT 84098-4857
Phone number: 435-940-9900
Copy
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