Organization
YELLOW SPRINGS DENTAL CARE JOHN T RUSSELL DDS INC.
Active
Other names
Yellow Springs Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN T RUSSELL DDS (CLINICIAN)
(937) 767-7731
Entity
Organization
Contact information
Practice address
1030 XENIA AVE, YELLOW SPRINGS, OH 45387-1632
(937) 767-7731
Mailing address
1030 XENIA AVE, PO BOX 839, YELLOW SPRINGS, OH 45387-1632
(937) 767-7731
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
30.013562
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679511489
NPI
OH
01
—
30.013562
STATE
OH
01
—
DN16600
STATE
FL
Enumeration date
05/03/2007
Last updated
05/19/2010
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