Individual
DR. ROBERT JAMES RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6865 OAK CREEK DR, COLUMBUS, OH 43229-1501
(641) 808-8478
Mailing address
14 LUCILLE DR, SYOSSET, NY 11791-3724
(516) 244-2552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.025583
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2017
Last updated
09/18/2018
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