Individual
DR. NICOLAS HENRY RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 PINCKNEY BLVD, NAVAL HOSPITAL BEAUFORT, BEAUFORT, SC 29902-6122
(843) 228-5577
(843) 228-5196
Mailing address
1 PINCKNEY BLVD, NAVAL HOSPITAL BEAUFORT, BEAUFORT, SC 29902-6122
(843) 228-5577
(843) 228-5196
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
039175
NY
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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