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Individual
DR. RUSSELL SCOTT WARREN
Active
Individual
DR. RUSSELL SCOTT WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20878
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
M9730
TX
Other
Enumeration date
02/02/2008
Last updated
09/30/2008
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