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Organization
SHANNON S. RUSSELL, DDS, INC.
Active
Organization
SHANNON S. RUSSELL, DDS, INC.
Active
Other names
1st Impressions Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON S RUSSELL DDS (PRESIDENT)
(209) 795-1535
Entity
Organization
Contact information
Practice address
2720 HIGHWAY 4, SUITE 3 & 4, ARNOLD, CA 95223
(209) 795-1535
(209) 795-6733
Mailing address
PO BOX 29, ARNOLD, CA 95223-0029
(209) 795-1535
(209) 795-6733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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