Russell, Jacob
Russell, Jacob is an sole proprietor health care provider with primary practice located at 525 Nautilus St , La Jolla CA 92037-6139. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Russell, Jacob can be contacted via phone (858) 459-4113.Contact Information
Primary practice address
525 Nautilus St
La Jolla CA 92037-6139
Phone: (858) 459-4113
Fax: (858) 459-4125
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 26521 | California |
Profile Details
| NPI number | 1750411963 |
|---|---|
| LBN Legal business name | Russell, Jacob |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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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