Individual
DR. RUSSELL KING BASS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
220 S DENTON TAP RD, STE 101, COPPELL, TX 75019-5098
(972) 393-6880
(972) 304-9341
Mailing address
220 S DENTON TAP RD, STE 101, COPPELL, TX 75019-5098
(972) 393-6880
(972) 304-9341
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14604
TX
Other
Enumeration date
06/01/2005
Last updated
07/08/2007
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