Organization
BENJAMIN T RUSSELL DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN RUSSELL (OWNER)
(503) 667-2442
Entity
Organization
Contact information
Practice address
742 NE DIVISION ST STE 102, GRESHAM, OR 97030-3979
(503) 667-2442
Mailing address
742 NE DIVISION ST STE 102, GRESHAM, OR 97030-3979
(503) 667-2442
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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