# CHARLES D. RUSSO, DMD,PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coral Springs Oral and Maxillofacial Surgery Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306035423
- **Authorized official:** DR. CHARLES D RUSSO DMD (PRESIDENT)
- **Authorized official phone:** (954) 752-1045

## Contact information

- **Practice address:** 2801 N UNIVERSITY DR, SUITE 102, CORAL SPRINGS, FL 33065-5057
- **Practice address phone:** (954) 752-1045
- **Practice address fax:** (954) 344-9651
- **Mailing address:** 2801 N UNIVERSITY DR, SUITE 102, CORAL SPRINGS, FL 33065-5057
- **Mailing address phone:** (954) 752-1045
- **Mailing address fax:** (954) 344-9651

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | DN0008338 | FL | Yes |

## Other

- **Enumeration date:** 10/16/2007
- **Last updated:** 04/22/2013