Organization
MORRISTOWN FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL S STAGGS DDS (SOLE DENTIST)
(765) 763-6412
Entity
Organization
Contact information
Practice address
347 W MAIN ST, MORRISTOWN, IN 46161-9792
(765) 763-6412
(765) 763-6815
Mailing address
347 W MAIN ST, MORRISTOWN, IN 46161-9792
(765) 763-6412
(765) 763-6815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19010197
IN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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