Individual
DAVID ALAN RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2D DENTAL BATTALION, NAVAL DENTAL CENTER, CAMP LEJEUNE, NC 28542-0130
(910) 451-2208
(910) 451-2208
Mailing address
PSC BOX 20130, CAMP LEJEUNE, NC 28542-0130
(910) 451-2208
(910) 451-8036
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008350
VA
Other
Enumeration date
12/15/2005
Last updated
07/08/2007
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