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Grant Christian Russell, DMD
General Practice Dentistry in Godfrey, Illinois
NPI 1366129223

Grant Christian Russell is a General Practice Dentistry based in Alton, IL and is specialized in General Practice. Grant Christian Russell practices in Godfrey, IL and has the professional credentials of DMD. The NPI Number for Grant Christian Russell is 1366129223 and holds a License No. 019.034468 (Illinois).

The current practice location address for Grant Christian Russell is 1203 W Delmar Ave, Godfrey, IL and can be reached out via phone at 618-466-3140.

Location: 1203 W Delmar Ave, Godfrey, IL, 62002-4753
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366129223
Provider Name
Grant Christian Russell
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
1203 W Delmar Ave, Godfrey, IL, 62002-4753
Phone Number
618-466-3140
Fax Number
Provider Enumeration Date
07/03/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1203 W Delmar Ave
City
Godfrey
State
Illinois
Zip
62035-1739
Phone Number
618-466-3140
Fax Number
person
Provider Business Mailing Address Details
Address
1203 W Delmar Ave
City
Godfrey
State
Illinois
Zip
62035-1739
Phone Number
618-466-3140
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
019.034468 (Illinois)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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