Individual
RICKY DALE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
526 LEGACY DR, STE 100, SMYRNA, TN 37167
(615) 459-8050
(615) 459-6023
Mailing address
526 LEGACY DR, STE 100, SMYRNA, TN 37167
(615) 459-8050
(615) 459-6023
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS0000003565
TN
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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