Ricky Dale Russell, DDS

NPI #1407963622 in Smyrna, Tennessee

Provider Information

NPI Number: 1407963622
Entity Type: Individual
Name: Ricky Dale Russell, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Aug 24, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 526 LEGACY DR
Address 2: STE 100
City: Smyrna
State: Tennessee
ZIP Code: 37167
Phone: (615) 459-8050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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