Organization
RUSSELL K KIRK, DDS, PC
Active
Organization
RUSSELL K KIRK, DDS, PC
Active
Other names
Tennessee Implant & Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL KEITH KIRK DDS (PRESIDENT)
(615) 453-7800
Entity
Organization
Contact information
Practice address
1409 WEST BADDOUR PARKWAY, SUITE F, LEBANON, TN 37087
(615) 453-7800
(615) 453-7858
Mailing address
1409 WEST BADDOUR PARKWAY, SUITE F, LEBANON, TN 37087
(615) 453-7800
(615) 453-7858
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7103
TN
Other
Enumeration date
03/28/2008
Last updated
05/03/2011
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