IndividualActive
Carl Russell, DMD, PHD
NPI 1902873276 · Orthodontics and Dentofacial Orthopedics Dentistry · Canton, GA
Provider details
- NPI number
- 1902873276
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DMD, PHD
- Sex
- Male
- License
- 11115 (GA)
Specialties & taxonomies
Dental Providers
Practice location
6488 Hickory Flat Hwy
Canton, GA 30115-7235
Phone: (770) 720-8138
Fax: (770) 720-7580
Approximate (ZIP-level) locationGet directions
Mailing address
6488 Hickory Flat Hwy
Canton, GA 30115-7235
Registry dates
- Enumerated
- 2006-03-04
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.