OrganizationActive
John Russell, III, D.M.D., PA
NPI 1184721367 · Orthodontics and Dentofacial Orthopedics Dentistry · Columbus, MS
Provider details
- NPI number
- 1184721367
- Entity type
- Organization
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Organization subpart
- No
- Authorized official
- John Russell, President(662) 328-1521
- License
- OR15888 (MS)
Specialties & taxonomies
Dental Providers
Practice location
206 Brookmoore Drive
Columbus, MS 39705
Phone: (662) 328-1521
Fax: (662) 328-1237
Approximate (ZIP-level) locationGet directions
Mailing address
206 Brookmoore Drive
Columbus, MS 39705
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2009-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.