Organization
RUSSELL W. CANNON DDS APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL WAYNE CANNON D.D.S. (PRESIDENT/OWNER)
(949) 552-7874
Entity
Organization
Contact information
Practice address
14150 CULVER DR STE 200, IRVINE, CA 92604-0322
(949) 552-7874
Mailing address
14150 CULVER DR STE 200, IRVINE, CA 92604-0322
(949) 552-7874
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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