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Grant Russell, DMD
NPI 1366129223 · on the registry since 2023 · sole proprietor
Practice
- Address
- 1203 W Delmar Ave
Godfrey, IL 62035 - Phone
- (618) 466-3140
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-07-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois