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Dr. Bradly Kalb Russell, DDS
Oral and Maxillofacial Surgery (Dentist) in Winston Salem, North Carolina
NPI 1932490307

Bradly Kalb Russell is a Oral and Maxillofacial Surgery (Dentist) based in Winston Salem, NC and is specialized in Oral and Maxillofacial Surgery. Bradly Kalb Russell practices in Winston Salem, NC and has the professional credentials of DDS. The NPI Number for Bradly Kalb Russell is 1932490307 and holds a License No. (North Carolina).

The current practice location address for Bradly Kalb Russell is 1601 S Hawthorne Rd, Winston Salem, NC and can be reached out via phone at 336-765-9550 and via fax at 336-765-9552.

Location: 1601 S Hawthorne Rd, Winston Salem, NC, 27103-4127
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932490307
Provider Name
Bradly Kalb Russell
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
1601 S Hawthorne Rd, Winston Salem, NC, 27103-4127
Phone Number
336-765-9550
Fax Number
336-765-9552
Provider Enumeration Date
04/20/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1601 S Hawthorne Rd
City
Winston Salem
State
North Carolina
Zip
27103-4127
Phone Number
336-765-9550
Fax Number
336-765-9552
person
Provider Business Mailing Address Details
Address
1601 S Hawthorne Rd
City
Winston Salem
State
North Carolina
Zip
27103-4127
Phone Number
336-765-9550
Fax Number
336-765-9552
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
30.0239911 (Ohio)
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.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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