DR. Russell Lang Forman, D.M.D.
NPI #1790836120 in Cambridge, Massachusetts
Provider Information
- NPI Number
- 1790836120
- Entity Type
- Individual
- Name
- DR. Russell Lang Forman, D.M.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- D.M.D.
- Enumeration Date
- Jan 14, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 875 MASSACHUSETTS AVE
- Address 2
- SUITE 63
- City
- Cambridge
- State
- Massachusetts
- ZIP Code
- 02139-3067
- Phone
- (617) 868-5500
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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