Individual
DR. SUSAN J RUSSETT-COLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
888 BRIGHTON AVE, PORTLAND, ME 04102-1004
(207) 772-4111
Mailing address
3 LEDGE HILL RD, GORHAM, ME 04038-2121
(207) 839-8149
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3008
ME
Other
Enumeration date
06/22/2006
Last updated
07/08/2007
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