# RUSSELL DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bremerton Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104249465
- **Authorized official:** DR. NATHAN GREGORY RUSSELL DDS (DOCTOR/OWNER)
- **Authorized official phone:** (360) 377-7621

## Contact information

- **Practice address:** 930 PARK AVE, BREMERTON, WA 98337-1551
- **Practice address phone:** (360) 377-7621
- **Practice address fax:** (360) 377-6265
- **Mailing address:** 930 PARK AVE, BREMERTON, WA 98337-1551
- **Mailing address phone:** (360) 377-7621
- **Mailing address fax:** (360) 377-6265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00009670 | WA | Yes |

## Other

- **Enumeration date:** 01/22/2014
- **Last updated:** 01/22/2014