Russell, Marilyn A.
Russell, Marilyn A. is an sole proprietor health care provider with primary practice located at 2844 Lake Park Dr , Jonesboro GA 30236-4133. She recently has only one registered license in Dental Providers / Periodontics, which is considered as her primary health care specialty. Russell, Marilyn A. can be contacted via phone (770) 478-8459.Contact Information
Primary practice address
2844 Lake Park Dr
Jonesboro GA 30236-4133
Phone: (770) 478-8459
Fax: (770) 478-6026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 008294 | Georgia |
Profile Details
| NPI number | 1912025784 |
|---|---|
| LBN Legal business name | Russell, Marilyn A. |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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