Individual
DR. RUSSELL A SEABOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
21 KIMBERLY LANE, BLUE RIDGE, GA 30513
(706) 632-6800
(706) 632-6802
Mailing address
PO BOX 640, 21 KIMBERLY LANE, BLUE RIDGE, GA 30513-0011
(706) 632-6800
(706) 632-6802
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10827
GA
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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