Michael Russo
NPI #1932594801 in Roseland, New Jersey
Provider Information
- NPI Number
- 1932594801
- Entity Type
- Individual
- Name
- Michael Russo
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Enumeration Date
- Mar 30, 2015
- Last Updated
- Jan 22, 2019
Practice Location
- Address
- 175 EAGLE ROCK AVE
- City
- Roseland
- State
- New Jersey
- ZIP Code
- 07068-1321
- Phone
- (973) 226-1973
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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