Individual
DR. RUSSELL TOM MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2964 PEACHTREE ROAD, SUITE 340, ATLANTA, GA 30305
(404) 239-9566
(404) 262-1744
Mailing address
2964 PEACHTREE ROAD, SUITE 340, ATLANTA, GA 30305
(404) 239-9566
(404) 262-1744
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN008520
GA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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