Organization
SMITH & RUSSELL DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLY KALB RUSSELL DDS (ORAL SURGEON)
(336) 765-9550
Entity
Organization
Contact information
Practice address
1601 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4127
(336) 765-9550
(336) 765-9552
Mailing address
1601 S HAWTHORNE RD, WINSTON SALEM, NC 27103-4127
(336) 765-9550
(336) 765-9552
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/31/2023
Last updated
05/31/2023
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