Individual
DR. RUSSELL B LITIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Mailing address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15201
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0272906
—
MA
01
—
X06251
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/30/2006
Last updated
08/28/2012
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