DR. Jacob Russell, DDS
NPI #1750411963 in La Jolla, California
Provider Information
- NPI Number
- 1750411963
- Entity Type
- Individual
- Name
- DR. Jacob Russell, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Mar 6, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 525 NAUTILUS ST
- City
- La Jolla
- State
- California
- ZIP Code
- 92037-6139
- Phone
- (858) 459-4113
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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