# MARK W. RUSSELL, DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Russell Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487390662
- **Authorized official:** MARK W. RUSSELL DMD (MEMBER AND MANAGER)
- **Authorized official phone:** (252) 633-4444

## Contact information

- **Practice address:** 2815 VILLAGE WAY, TRENT WOODS, NC 28562-7351
- **Practice address phone:** (252) 633-4444
- **Practice address fax:** (252) 638-1586
- **Mailing address:** 2815 VILLAGE WAY, TRENT WOODS, NC 28562-7351
- **Mailing address phone:** (252) 633-4444

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2022
- **Last updated:** 06/03/2022