JACOB RUSSELL

LA JOLLA, CA
NPI1750411963
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: CA  26521)
Enumeration Date2007-03-06
Last Update Date2007-07-08
Business Address
Dr. JACOB RUSSELL DDS
525 NAUTILUS ST
LA JOLLA, CA 92037-6139
Phone number: 858-459-4113
Mailing Address
Dr. JACOB RUSSELL DDS
525 NAUTILUS ST
LA JOLLA, CA 92037-6139
Phone number: 858-459-4113
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