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Individual

DR. RUSSELL W POE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
83 SHENANGO ST, GREENVILLE, PA 16125
(724) 588-3010
(724) 588-3011
Mailing address
83 SHENANGO ST, GREENVILLE, PA 16125
(724) 588-3010
(724) 588-3011

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS020113L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005126620001
PA
Enumeration date
03/27/2007
Last updated
07/08/2007
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