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Individual
LOUIS RUSSELL JR.
Active
Individual
LOUIS RUSSELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18152
TX
Other
Enumeration date
09/03/2015
Last updated
02/05/2020
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