Individual
MS. JAMIE ELLEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
26 QUEEN ST STE 13, WORCESTER, MA 01610-2478
(508) 963-7300
Mailing address
13 A VINTON RD, CHARLTON, MA 01507-6544
(508) 688-9890
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13270
MA
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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