Organization
MONUMENT DENTAL ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL D MORRELL DMD, MDS (OWNER)
(901) 491-0971
Entity
Organization
Contact information
Practice address
120 S GROVE PARK RD, MEMPHIS, TN 38117-3104
(901) 491-0971
Mailing address
120 S GROVE PARK RD, MEMPHIS, TN 38117-3104
(901) 491-0971
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
9030
TN
Other
Enumeration date
10/11/2016
Last updated
02/01/2017
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