Russo Dental LLC
NPI #1538557848 in Brookfield, Wisconsin
Provider Information
- NPI Number
- 1538557848
- Entity Type
- Organization
- Organization Name
- Russo Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 8, 2015
- Last Updated
- Jan 8, 2015
Practice Location
- Address
- 12690 W NORTH AVE
- City
- Brookfield
- State
- Wisconsin
- ZIP Code
- 53005-4636
- Phone
- (262) 784-3740
Authorized Official
- Name
- DR. NICHOLAS VITO RUSSO, D.D.S.
- Title
- OWNER
- Phone
- (262) 894-1071
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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