Most Relevant Information
Provider Data
| NPI Number: | 1003548967 |
| Provider Name: | MARIA FAITH RUSSELL RDH |
| Entity Type: | Individual |
| Taxonomy Code: | 124Q00000X |
| Specialty: | Dental Hygienist |
| License Number: | 12750 |
Most Important Dates
| Enumeration Date: | 06/29/2022 |
| Last Updated: | 06/29/2022 |
Provider Practice Location
3011 N MICHIGAN ST
PITTSBURG
KS
667622546
Practice Location Phone/Fax
| Phone: | 6202319873 |
| Fax: |
Provider Mailing Location
3015 N MICHIGAN ST
PITTSBURG
KS
667622546
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |