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Organization
GARRETT RUSSIKOFF D.M.D., INC.
Active
Organization
GARRETT RUSSIKOFF D.M.D., INC.
Active
Other names
Woodstone Plaza Dental
Organization subpart
No
Provider details
NPI number
Authorized official
GARRETT RUSSIKOFF DMD (PRESIDET/ CEO)
(818) 701-5126
Entity
Organization
Contact information
Practice address
18911 NORDHOFF ST STE 35, NORTHRIDGE, CA 91324-3784
(818) 701-5126
Mailing address
18911 NORDHOFF ST STE 35, NORTHRIDGE, CA 91324-3784
(818) 701-5126
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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