Organization
RANDALL J RUSSELL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL J RUSSELL DDS (OWNER)
(720) 870-1451
Entity
Organization
Contact information
Practice address
20971 E SMOKY HILL RD, SUITE 201, CENTENNIAL, CO 80015-5186
(720) 870-1451
(720) 870-1456
Mailing address
20971 E SMOKY HILL RD, SUITE 201, CENTENNIAL, CO 80015-5186
(720) 870-1451
(720) 870-1456
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
DEN.00201913
CO
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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