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1336269109
DAVID LEE RUSSELL
FORT WALTON BEACH, FL
NPI
1336269109
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: FL 9126)
Enumeration Date
2007-03-29
Last Update Date
2007-07-08
Business Address
Dr. DAVID LEE RUSSELL DMD, MS.
14 RACETRACK RD NW
FORT WALTON BEACH, FL 32547-1642
Phone number: 850-863-3194
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Mailing Address
Dr. DAVID LEE RUSSELL DMD, MS.
14 RACETRACK RD NW
FORT WALTON BEACH, FL 32547-1642
Phone number: 850-863-3194
Copy
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