Garrett Russikoff D.m.d., Inc.

NPI #1124599006 in Northridge, California

Provider Information

NPI Number: 1124599006
Entity Type: Organization
Organization Name: Garrett Russikoff D.m.d., Inc.
Primary Specialty: Dentist
Enumeration Date: Dec 17, 2018
Last Updated: Dec 17, 2018

Practice Location

Address: 18911 NORDHOFF ST STE 35
City: Northridge
State: California
ZIP Code: 91324-3784
Phone: (818) 701-5126

Authorized Official

Name: GARRETT RUSSIKOFF, DMD
Title: PRESIDET/ CEO
Phone: (818) 701-5126

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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