DR. Mary Kathleen Russo, D.M.D

NPI #1710030234 in Sea Girt, New Jersey

Provider Information

NPI Number: 1710030234
Entity Type: Individual
Name: DR. Mary Kathleen Russo, D.M.D
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: D.M.D
Enumeration Date: Jan 19, 2007
Last Updated: Jul 10, 2015

Practice Location

Address: 804 HIGHWAY 71
City: Sea Girt
State: New Jersey
ZIP Code: 08750-2807
Phone: (732) 449-6564

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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