Individual
DR. RUSSELL CHARLES HURST JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
40 WESMARK CT, SUMTER, SC 29150-1996
(803) 469-2062
(803) 469-2063
Mailing address
40 WESMARK CT, SUMTER, SC 29150-1996
(803) 469-2062
(803) 469-2063
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2501
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2501
STATE LICENSE
SC
Enumeration date
04/16/2007
Last updated
04/20/2020
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