Individual
DR. MATTHEW AARON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
315 MCHUGH BLVD, 2D DENBN/NDC, CAMP LEJEUNE, NC 28547-2511
(910) 451-2208
(910) 451-8036
Mailing address
315 MCHUGH BLVD, 2D DENBN/NDC, CAMP LEJEUNE, NC 28547-2511
(910) 451-2208
(910) 451-8036
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-4069
ID
Other
Enumeration date
08/23/2007
Last updated
07/01/2008
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