Dr. John Russell III, D.M.D.
Dentist, Orthodontics and Dentofacial Orthopedics in Columbus, MS. Individual provider (NPI-1).
NPI number1821231663
StatusActive
Last updated in NPPESApr 24, 2009
Details
- NPI
- 1821231663
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Russell III
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 9, 2009
- Last updated
- Apr 24, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | 2100-84 | MS | Yes |
Practice location
206 N Brookmoore DrColumbus, MS 39705-2020
Phone 662-328-1521 · Fax 662-328-1237
Mailing address
206 N Brookmoore DrColumbus, MS 39705-2020
Phone 662-328-1521 · Fax 662-328-1237
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