GRANT RUSSELL, DMD

Dentist - General Practice

Active Individual
NPI: 1366129223

Practice Address

1203 W DELMAR AVE
Godfrey, IL 62035

Phone: (618) 466-3140

Specialties

Specialty Code Primary License
Dentist - General Practice 1223G0001X Yes 019.034468 (IL)

Frequently Asked Questions

NPI 1366129223 is the National Provider Identifier for GRANT RUSSELL, DMD, a Dentist - General Practice provider located in Godfrey, IL. This NPI was enumerated on July 3, 2023.
GRANT RUSSELL, DMD practices at 1203 W DELMAR AVE, Godfrey, IL 62035.

Quick Facts

NPI
1366129223
Type
Individual
Enumerated
Jul 3, 2023
Last Updated
Jul 3, 2023