Provider Demographics
NPI:1043238157
Name:SETTLE, RUSSELL ALAN JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:ALAN
Last Name:SETTLE
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 GOETZ LN
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-9663
Mailing Address - Country:US
Mailing Address - Phone:270-684-9244
Mailing Address - Fax:270-685-1193
Practice Address - Street 1:4921 GOETZ LN
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-9663
Practice Address - Country:US
Practice Address - Phone:270-684-9244
Practice Address - Fax:270-685-1193
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY66371223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist