# MORRISTOWN FAMILY DENTISTRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154665073
- **Authorized official:** DR. RUSSELL S STAGGS DDS (SOLE DENTIST)
- **Authorized official phone:** (765) 763-6412

## Contact information

- **Practice address:** 347 W MAIN ST, MORRISTOWN, IN 46161-9792
- **Practice address phone:** (765) 763-6412
- **Practice address fax:** (765) 763-6815
- **Mailing address:** 347 W MAIN ST, MORRISTOWN, IN 46161-9792
- **Mailing address phone:** (765) 763-6412
- **Mailing address fax:** (765) 763-6815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 19010197 | IN | Yes |

## Other

- **Enumeration date:** 11/15/2012
- **Last updated:** 11/15/2012