Marilyn A. Russell in Jonesboro - Periodontics
Marilyn A. Russell - NPI 1912025784
Marilyn A. Russell is a Periodontics in Jonesboro, Georgia. Marilyn A. Russell practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Marilyn A. Russell is 1912025784. The last update date is 2007-07-09.
Marilyn A. Russell's current location address is 2844 Lake Park Dr, Jonesboro, Georgia. You can contact this provider via phone number 7704788459 and fax number 7704786026. The mailing address for Marilyn A. Russell is 2844 Lake Park Dr, Jonesboro, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marilyn A. Russell |
|---|---|
| Address | 2844 Lake Park Dr, Jonesboro, Georgia |
| Phone Number | 7704788459 |
| Fax Number | 7704786026 |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1912025784 |
|---|---|
| Provider Enumeration Date | 2007-03-27 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 2844 Lake Park Dr |
|---|---|
| City | Jonesboro |
| State | Georgia (GA) |
| Post Code | 302364133 |
| Phone Number | 7704788459 |
| Fax Number | 7704786026 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 8294 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Marilyn A. Russell by the Centers for Medicare & Medicaid Services?
The Marilyn A. Russell has been assigned the NPI (National Provider Identifier) 1912025784 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Marilyn A. Russell's physical address?
The Marilyn A. Russell is physically located at 2844 Lake Park Dr, in the city of Jonesboro, GA, with the postal code 302364133.
What is the Marilyn A. Russell's area of specialization and corresponding taxonomy classification?
The Marilyn A. Russell's specialty field is Periodontics, and it falls under the taxonomy code 1223P0300X, which categorizes healthcare providers based on their specialties.
On what date did Marilyn A. Russell receive its 1912025784 assignment from the Centers for Medicare & Medicaid Services?
The Marilyn A. Russell was assigned its 1912025784 on 2007-03-27, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Marilyn A. Russell, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Marilyn A. Russell, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2007-07-09.
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