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Dr. Willard Dean Russell JR., DDS
Oral and Maxillofacial Surgery (Dentist) in Martinsburg, West Virginia
NPI 1215010285

Willard Dean Russell JR. is a Oral and Maxillofacial Surgery (Dentist) based in Martinsburg, WV and is specialized in Oral and Maxillofacial Surgery. Willard Dean Russell JR. practices in Martinsburg, WV and has the professional credentials of DDS. The NPI Number for Willard Dean Russell JR. is 1215010285 and holds a License No. 2483 (West Virginia).

The current practice location address for Willard Dean Russell JR. is 1007 Sushruta Drive, Martinsburg, WV and can be reached out via phone at 304-263-0991 and via fax at 304-274-9546.

Location: 1007 Sushruta Drive, Martinsburg, WV, 25401
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215010285
Provider Name
Willard Dean Russell JR.
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1007 Sushruta Drive, Martinsburg, WV, 25401
Phone Number
304-263-0991
Fax Number
304-274-9546
Provider Enumeration Date
10/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
066637 01 TRIGON
0136408000 05 WV
DF52 01 MD BCBS MD
LK72 01 MD DENTAL/MEDICAL
institution
Provider Business Practice Location Address Details
Address
1007 Sushruta Drive
City
Martinsburg
State
West Virginia
Zip
25401
Phone Number
304-263-0991
Fax Number
304-274-9546
person
Provider Business Mailing Address Details
Address
1007 Sushruta Drive
City
Martinsburg
State
West Virginia
Zip
25401
Phone Number
304-263-0991
Fax Number
304-274-9546
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
2483 (West Virginia)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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