| Keith Edmund Russell, DMD | |
|
495 Woodford St, Portland, ME 04103-2438 | |
| (207) 772-6966 | |
| (207) 761-0756 |
| Full Name | Keith Edmund Russell |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 495 Woodford St, Portland, Maine |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447328752 | NPI | - | NPPES |
| 264030099 | Medicaid | ME | |
| 043377401 | Other | ME | INDIVIDUAL TAX ID # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3414 (Maine) | Secondary |
| 1223G0001X | Dentist - General Practice | 3414 (Maine) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Edmund Russell, DMD 495 Woodford St, Portland, ME 04103-2438 Ph: (207) 772-6966 | Keith Edmund Russell, DMD 495 Woodford St, Portland, ME 04103-2438 Ph: (207) 772-6966 |
Dr. Albert Gallemit Abena, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 716 Stevens Ave, Portland, ME 04103 Phone: 207-221-4687 | |
Dr. Paul Harvey Pasternack, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1 College St, Portland, ME 04103 Phone: 207-221-4747 | |
Franchesca Vargas, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 190 Park Ave, Portland, ME 04102 Phone: 207-874-1028 | |
Dr. Jacob Nichols, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 163 Pleasant Ave, Portland, ME 04103 Phone: 207-771-2093 | |
Dr. Ralph H Yarn, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1330 Congress Street, Portland, ME 04102 Phone: 207-773-3738 Fax: 207-773-5872 | |
Dr. Stephen Charles Palmer, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1 College St, Portland, ME 04103 Phone: 207-221-4747 Fax: 207-331-4805 | |
Dr. Gregory V Sarka, DDS,MD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1250 Forest Ave Unit 5, Portland, ME 04103 Phone: 207-387-2055 Fax: 207-387-2022 |