Individual
DR. JEFFREY CARL RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
148 NORTH RD, EAST WINDSOR, CT 06088-9502
(860) 627-5235
Mailing address
148 NORTH RD, EAST WINDSOR, CT 06088-9502
(860) 627-5235
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9049
CT
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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