WILLARD DEAN RUSSELL

MARTINSBURG, WV
NPI1215010285
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: WV  2483)
Additional Taxonomies1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: MD  6261)
1223S0112X Dentist Oral and Maxillofacial Surgery
(Licence: PA  DS030508L)
Enumeration Date2006-10-23
Last Update Date2012-05-30
Business Address
DR. WILLARD DEAN RUSSELL DDS
1007 SUSHRUTA DRIVE
MARTINSBURG, WV 25401
Phone number: 304-263-0991
Mailing Address
DR. WILLARD DEAN RUSSELL DDS
1007 SUSHRUTA DRIVE
MARTINSBURG, WV 25401
Phone number: 304-263-0991