Organization
JASON E. RUSSELL, DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY R RUSSELL (ACCOUNT MANAGER)
(336) 884-2212
Entity
Organization
Contact information
Practice address
510 FERNDALE BLVD, SUITE 102, HIGH POINT, NC 27262-4761
(336) 884-2212
(336) 884-4477
Mailing address
510 FERNDALE BLVD, SUITE 102, HIGH POINT, NC 27262-4761
(336) 884-2212
(336) 884-4477
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9115
NC
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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