ALISA L RUSSELL

JACKSONVILLE, FL
NPI1588190052
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy124Q00000X Dental Hygienist
(Licence: FL  DH 23693)
Enumeration Date2017-05-03
Last Update Date2017-05-03
Business Address
Mrs. ALISA L RUSSELL RDH
2080 CHILD ST BLDG 964 DENTAL
JACKSONVILLE, FL 32214-5005
Phone number: 904-546-7175
Mailing Address
Mrs. ALISA L RUSSELL RDH
2080 CHILD ST P.O. BOX 8 BLDG 964
JACKSONVILLE, FL 32214-5005
Phone number: 904-546-7175
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