Organization
SHARON RUSSELL DDS PC
Active
Other names
The Maryland Oral Surgery Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON SHERISE RUSSELL DDS (ORAL SURGEON)
(240) 478-7030
Entity
Organization
Contact information
Practice address
9632 PENNSYLVANIA AVE, UPPER MARLBORO, MD 20772-3670
(240) 478-7030
Mailing address
3305 OLD LARGO RD, UPPER MARLBORO, MD 20772-7811
(240) 478-7030
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14351
MD
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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