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Jacob Russell, DDS
NPI 1750411963 · on the registry since 2007 · sole proprietor
Practice
- Address
- 525 Nautilus St
La Jolla, CA 92037 - Phone
- (858) 459-4113
- Fax
- (858) 459-4125
- Organisation at this address
- Erez Nosrati, Dmd, Inc.
Irene Nosrati, Dds, And Erez Nosrati, Dmd, Inc.Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California