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Individual

DR. DONALD M RUSSELL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.,P.C.

Contact information

Practice address
2425 MEDICAL CENTER PKWY, SELMA, AL 36701-7756
(334) 875-1330
(334) 875-6284
Mailing address
2425 MEDICAL CENTER PKWY, SELMA, AL 36701-7756
(334) 875-1330
(334) 875-6284

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3063
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000095993
AL
Enumeration date
08/21/2006
Last updated
07/08/2007
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