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Individual
DR. ANGELA MICHELLE ILLUZZI-RUSSO
Active
Individual
DR. ANGELA MICHELLE ILLUZZI-RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
052809
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI02347100
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DEN4836
ME
Other
Enumeration date
01/22/2007
Last updated
02/04/2021
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