Individual
DR. NICHOLAS M DELLORUSSO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
55 FRUIT ST, CPZ 401, BOSTON, MA 02114-2621
(617) 726-1076
(617) 724-6681
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
11263
MA
Other
Enumeration date
10/27/2005
Last updated
07/08/2007
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