Individual
RUSSELL W GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1109 W CHESTNUT ST, ROGERS, AR 72756-3529
(479) 633-8846
Mailing address
1109 W CHESTNUT ST, ROGERS, AR 72756-3529
(479) 633-8846
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4523
AR
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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