Individual
DR. ROBERT ROSS RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
2402 LOGANVILLE HWY, SUITE 500, GRAYSON, GA 30017-1689
(770) 236-9660
(770) 236-9664
Mailing address
2402 LOGANVILLE HWY, SUITE 500, GRAYSON, GA 30017-1689
(770) 236-9660
(770) 236-9664
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN012716
GA
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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