Organization
DENTAL ASSOICATES OF GLOUCESTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ANTHONY RUSSO D.M.D. (PARTNER)
(978) 281-1337
Entity
Organization
Contact information
Practice address
321 WASHINGTON ST, GLOUCESTER, MA 01930-4837
(978) 281-1337
(978) 281-7573
Mailing address
321 WASHINGTON ST, GLOUCESTER, MA 01930-4837
(978) 281-1337
(978) 281-7573
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12116
MA
1223G0001X
General Practice Dentistry
Primary
20806
MA
Other
Enumeration date
07/06/2006
Last updated
08/22/2020
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