Individual
DR. TIMOTHY ELMER RUSSELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2616 SHERWOOD HALL LANE, SUITE 405, ALEXANDRIA, VA 22306
(703) 360-1776
(703) 360-1776
Mailing address
2616 SHERWOOD HALL LANE, SUITE 405, ALEXANDRIA, VA 22306
(703) 360-1776
(703) 360-1776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401003282
VA
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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