Individual
DR. RUSSELL D CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MD
Contact information
Practice address
1 LAKEWAY CENTRE CT, LAKEWAY, TX 78734-2621
(512) 263-9544
(512) 263-9549
Mailing address
PO BOX 49500, AUSTIN, TX 78765-9500
(512) 498-0114
(512) 467-0363
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
20912
TX
Other
Enumeration date
02/04/2008
Last updated
07/30/2013
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