| Eric G Russell DDS LLC | |
|
5685 S 1475 E Ste 4a Ogden UT 84403-4598 | |
| (801) 475-4646 | |
| Not Available |
| Full Name | Eric G Russell DDS LLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5685 S 1475 E Ste 4a, Ogden, Utah |
| Authorized Official Name and Position | Eric Gordon Russell (OWNER/MEMBER MANAGER) |
| Authorized Official Contact | 8016444605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eric G Russell DDS LLC 5685 S 1475 E Ste 4a Ogden UT 84403-4598 Ph: (801) 475-4646 | Eric G Russell DDS LLC 5685 S 1475 E Ste 4a Ogden UT 84403-4598 Ph: (801) 475-4646 |
| NPI Number | 1003462292 |
|---|---|
| Provider Enumeration Date | 08/13/2019 |
| Last Update Date | 08/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003462292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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