BROCK TERRY RUSSELL

SURPRISE, AZ
NPI1346133576
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist General Practice
(Licence: AZ  D012505)
Enumeration Date2025-05-29
Last Update Date2025-05-29
Business Address
DR. BROCK TERRY RUSSELL DMD
13761 N LITCHFIELD RD STE 103
SURPRISE, AZ 85379-4272
Phone number: 623-975-3933
Mailing Address
DR. BROCK TERRY RUSSELL DMD
2940 W WAGONER RD
PHOENIX, AZ 85053-1122
Phone number: 623-518-5233
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