DR. Philip Hostage Russell, D.M.D.

NPI #1861526568 in Manchester, Vermont

Provider Information

NPI Number: 1861526568
Entity Type: Individual
Name: DR. Philip Hostage Russell, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Mar 15, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4313 MAIN ST.
City: Manchester
State: Vermont
ZIP Code: 05254
Phone: (802) 362-2151

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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