Individual
DR. HARRY PATRICK RUSSELL II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4736 STARKEY RD, SUITE B, ROANOKE, VA 24018-8547
(540) 772-7135
(540) 772-1317
Mailing address
4736 STARKEY RD, SUITE B, ROANOKE, VA 24018-8547
(540) 772-7135
(540) 772-1317
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
401007391
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497941058
TYPE II NPI NUMBER
VA
Enumeration date
10/24/2014
Last updated
10/24/2014
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