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Organization
LEGACY HILL DENTISTRY
Active
Organization
LEGACY HILL DENTISTRY
Active
Other names
Ricky Dale Russell, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY DALE RUSSELL DDS (OWNER)
(615) 459-8050
Entity
Organization
Contact information
Practice address
526 LEGACY DR, SMYRNA, TN 37167-6750
(615) 459-8050
(615) 459-6023
Mailing address
526 LEGACY DR, SMYRNA, TN 37167-6750
(615) 459-8050
(615) 459-6023
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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