Individual
DR. RUSEL PAUL HOLLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.S.
Contact information
Practice address
4426 W KL AVE, KALAMAZOO, MI 49006-5723
(269) 353-7700
(269) 353-7788
Mailing address
4426 W KL AVE, KALAMAZOO, MI 49006-5723
(269) 353-7700
(269) 353-7788
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901012996
MI
Other
Enumeration date
09/28/2006
Last updated
07/08/2007
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