DR. Chad D Russell, D.M.D.

NPI #1356471213 in Three Forks, Montana

Provider Information

NPI Number: 1356471213
Entity Type: Individual
Name: DR. Chad D Russell, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Mar 7, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 123 MAIN ST
Address 2: SUITE #1
City: Three Forks
State: Montana
ZIP Code: 59752-0850
Phone: (406) 285-5234

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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