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Contact Information

MONTE H RUSSELL, DDS
29 PLYMOUTH ST NE
LE MARS, IA51031
 Phone: 712-546-8823
 Fax: 712-546-9477
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for MONTE H RUSSELL · (Male)

NPI Number 1235142803
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 08/14/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 05974
  • IA Medicaid 0005173
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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