Individual
DR. ASHLEY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6110
AL
1223G0001X
General Practice Dentistry
6110
AL
1223P0221X
Pediatric Dentistry
Primary
10976
TN
1223P0221X
Pediatric Dentistry
33891
TX
Other
Enumeration date
06/27/2014
Last updated
07/28/2019
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