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Organization
SHARON RUSSELL DDS PC
Active
Organization
SHARON RUSSELL DDS PC
Active
Other names
The Maryland Oral Surgery Group and Implant Center of Bowie
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK RUSSELL (OPERATIONS MANAGER)
(301) 967-0183
Entity
Organization
Contact information
Practice address
14300 GALLANT FOX LN STE 220, BOWIE, MD 20715-4033
(301) 967-0183
(301) 576-5800
Mailing address
9632 MARLBORO PIKE, UPPER MARLBORO, MD 20772-3767
(301) 967-0183
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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