Provider Demographics
NPI:1326060500
Name:POSEY, RUSSELL GORDON (DDS,MPH)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:GORDON
Last Name:POSEY
Suffix:
Gender:M
Credentials:DDS,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-6047
Mailing Address - Country:US
Mailing Address - Phone:970-224-5599
Mailing Address - Fax:970-224-0731
Practice Address - Street 1:1001 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-6047
Practice Address - Country:US
Practice Address - Phone:970-224-5599
Practice Address - Fax:970-224-0731
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COBP56459981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice