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Individual

PETER J RUSSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
567 SOUTHBRIDGE, AUBURN, MA 01520
(508) 832-3317
(508) 832-5374
Mailing address
63 WOODBURY AVE, HYANNIS, MA 02061
(617) 699-4862
(508) 832-5374

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19637
MA

Other

Enumeration date
11/17/2006
Last updated
07/08/2007
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