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Contact Information

DAVID W RUSSELL, DMD
4171 NORTHRISE DRIVE
LAS CRUCES, NM88011
 Phone: 575-521-9375
 Fax: 575-521-2637
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DAVID W RUSSELL · (Male)

NPI # 1164915294
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 06/13/2018
Last updated 08/12/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • NM License # DD4897
  • NM Medicaid 81627718
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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