Individual
DR. JOHN RUSSELL III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
206 N BROOKMOORE DR, COLUMBUS, MS 39705-2020
(662) 328-1521
(662) 328-1237
Mailing address
206 N BROOKMOORE DR, COLUMBUS, MS 39705-2020
(662) 328-1521
(662) 328-1237
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2100-84
MS
Other
Enumeration date
04/09/2009
Last updated
04/24/2009
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