Individual
MS. SALLY W RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
725 OLD POST RD, FAIRFIELD, CT 06824-6684
(203) 256-3020
(203) 254-8850
Mailing address
725 OLD POST RD, FAIRFIELD, CT 06824-6684
(203) 256-3020
(203) 254-8850
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
002137
CT
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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