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Dr. David Lee Russell SR., DMD,MS
Pediatric Dentist in Fort Walton Beach, Florida
NPI 1336269109

David Lee Russell SR. is a Pediatric Dentist based in Fort Walton Beach, FL and is specialized in Pediatric Dentistry. David Lee Russell SR. practices in Fort Walton Beach, FL and has the professional credentials of DMD,MS. The NPI Number for David Lee Russell SR. is 1336269109 and holds a License No. 9126 (Florida).

The current practice location address for David Lee Russell SR. is 14 Racetrack Rd Nw, Fort Walton Beach, FL and can be reached out via phone at 850-863-3194 and via fax at 850-863-8875.

Location: 14 Racetrack Rd Nw, Fort Walton Beach, FL, 32547-1642
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336269109
Provider Name
David Lee Russell SR.
Credential
DMD,MS
Provider Entity Type
Individual
Gender
Male
Address
14 Racetrack Rd Nw, Fort Walton Beach, FL, 32547-1642
Phone Number
850-863-3194
Fax Number
850-863-8875
Provider Enumeration Date
03/29/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
14 Racetrack Rd Nw
City
Fort Walton Beach
State
Florida
Zip
32547-1642
Phone Number
850-863-3194
Fax Number
850-863-8875
person
Provider Business Mailing Address Details
Address
14 Racetrack Rd Nw
City
Fort Walton Beach
State
Florida
Zip
32547-1642
Phone Number
850-863-3194
Fax Number
850-863-8875
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
9126 (Florida)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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