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Individual

DR. RUSSELL LEON HARRISON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
33 E BROADWAY, STE. 290, COLUMBIA, MO 65203-4207
(573) 449-0794
(573) 443-7333
Mailing address
33 E BROADWAY, STE. 290, COLUMBIA, MO 65203-4207
(573) 449-0794
(573) 443-7333

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
010659
MO

Other

Enumeration date
11/06/2006
Last updated
07/09/2007
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