Russell, Stacey W
Russell, Stacey W is an individual health care provider with primary practice located at 22 Truck House Rd Ste 3 , Severna Park MD 21146-2728. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Russell, Stacey W can be contacted via phone (410) 647-4269.Contact Information
Primary practice address
22 Truck House Rd Ste 3
Severna Park MD 21146-2728
Phone: (410) 647-4269
Fax: (410) 544-5910
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 11897 | Maryland |
Profile Details
| NPI number | 1811267487 |
|---|---|
| LBN Legal business name | Russell, Stacey W |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2012 |
| Last updated | Jan 12th, 2012 - about 13 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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