Russell, William Dirk
Russell, William Dirk is an sole proprietor health care provider with primary practice located at 8014 Cumming Hwy Suite 401 , Canton GA 30115. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Russell, William Dirk can be contacted via phone (770) 345-2010.Contact Information
Primary practice address
8014 Cumming Hwy Suite 401
Canton GA 30115
Phone: (770) 345-2010
Fax: (770) 345-0571
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DN012158 | Kentucky |
Profile Details
| NPI number | 1114007887 |
|---|---|
| LBN Legal business name | Russell, William Dirk |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Dec 6th, 2021 - about 3 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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