Russell, Tamara Dunn

Russell, Tamara Dunn is an individual health care provider with primary practice located at 16 Felton Pl # B , Cartersville GA 30120-2152. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Russell, Tamara Dunn can be contacted via phone (770) 382-3536.

Contact Information

Primary practice address
16 Felton Pl # B Cartersville GA 30120-2152
Phone: (770) 382-3536
Fax: (770) 382-1915
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN011041 Georgia

Profile Details

NPI number 1922166164
LBN Legal business name Russell, Tamara Dunn
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
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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Identifiers

StateTypeNumberIssuer
All States NPI 1922166164 NPPES
Georgia Other 100299 AVESIS MEDICAID
Georgia Other 9181142 AVESIS MEDICAID
Georgia MEDICAID 00945128A AVESIS MEDICAID

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