Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JOHN DOUGLAS RUSSELL, DDS
ActiveMR. JOHN DOUGLAS RUSSELL, DDS is a Dentist healthcare provider located in SHASTA LAKE CITY, California. NPI 1902958077 is currently active in the NPPES registry. Verify at CMS.
Dentist · SHASTA LAKE CITY, CA
Registration Details
- NPI Number
- 1902958077
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 17, 2007 (19.555309431055 yrs)
- Last Updated
- Jul 8, 2007
- License
-
20042 (CA)
Practice Information
- Address
-
4178 ASHBY COURTSHASTA LAKE CITY, CA, 96019Browse CA providers · Browse ZIP 96019
- Phone
- 5302752910
- Fax
- 5302759335
- Primary Specialty
-
Dentist
122300000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.