Gregory S Russell, Dmd, P.A.

LBN: Gregory S Russell, Dmd, P.A.
Gregory S Russell, Dmd, P.A. is an health care organization with primary practice located at 11200 Racetrack Rd Ste 204 , Berlin MD 21811-3808. The organization recently has only one registered license in Dental Providers / Endodontics, which is considered as the primary health care specialty. Gregory S Russell, Dmd, P.A. can be contacted via phone (410) 208-3333, or through Russell, Gregory S via phone (410) 208-3333.

Contact Information

Primary practice address
11200 Racetrack Rd Ste 204 Berlin MD 21811-3808
Phone: (410) 208-3333
Fax: (410) 208-3330
Website:
Map and Directions
Authorized official contact:
Name: Russell, Gregory S Doctor of Dental Medicine (DMD)
Phone: (410) 208-3333

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 13423 Maryland

Profile Details

NPI number 1619267903
LBN Legal business name Gregory S Russell, Dmd, P.A.
DBA Doing business as
Authorized official Russell, Gregory S Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 8th, 2011
Last updated Dec 23rd, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619267903 NPPES
Maryland Other 13423 DENTAL LIC#

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