Provider Demographics
NPI:1154528636
Name:RUSSELL, ONEAL FRANKLIN III (DDS)
Entity type:Individual
Prefix:DR
First Name:ONEAL
Middle Name:FRANKLIN
Last Name:RUSSELL
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 DEFENSE HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8922
Mailing Address - Country:US
Mailing Address - Phone:410-980-3730
Mailing Address - Fax:
Practice Address - Street 1:166 DEFENSE HWY STE 201
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-8922
Practice Address - Country:US
Practice Address - Phone:410-263-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13894122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist