Individual
DR. MICHAEL P RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.D.
Contact information
Practice address
67 HIGHLAND ST, WORCESTER, MA 01609-2734
(508) 791-5529
(508) 791-4546
Mailing address
24 WALKER ST, NEWTONVILLE, MA 02460-1518
(617) 964-1268
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
19644
MD
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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