Organization
RUSSELL M. GORMAN, DDS., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL M GORMAN D.D.S. (OWNER/PRESIDENT)
(501) 321-1977
Entity
Organization
Contact information
Practice address
308 WEST ST LOUIS STREET, HOT SPRINGS, AR 71913
(501) 321-1977
(501) 321-1750
Mailing address
308 WEST ST LOUIS STREET, HOT SPRINGS, AR 71913
(501) 321-1977
(501) 321-1750
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
AR3238
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5T948
ABCBS
—
Enumeration date
12/23/2008
Last updated
12/23/2008
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