Individual
MR. RUSSELL PUTERBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH, BS
Contact information
Practice address
1337 N QUINCY AVE, OGDEN, UT 84404-3399
(801) 388-4034
Mailing address
1337 N QUINCY AVE, OGDEN, UT 84404-3399
(801) 388-4034
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
101503
NV
124Q00000X
Dental Hygienist
24320
CA
124Q00000X
Dental Hygienist
6457
AZ
124Q00000X
Dental Hygienist
Primary
7024861-9920
UT
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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