| Ricky Dale Russell, Dds | |
|
526 Legacy Dr Smyrna TN 37167-6750 | |
| (615) 459-8050 | |
| (615) 459-6023 |
| Full Name | Ricky Dale Russell, Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 526 Legacy Dr, Smyrna, Tennessee |
| Authorized Official Name and Position | Ricky Dale Russell (OWNER) |
| Authorized Official Contact | 6154598050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ricky Dale Russell, Dds 526 Legacy Dr Smyrna TN 37167-6750 Ph: (615) 459-8050 | Ricky Dale Russell, Dds 526 Legacy Dr Smyrna TN 37167-6750 Ph: (615) 459-8050 |
| NPI Number | 1003151390 |
|---|---|
| Provider Enumeration Date | 11/28/2012 |
| Last Update Date | 11/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003151390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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