Individual
TONI LYNN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
233 HAZARD AVE, ENFIELD, CT 06082-4647
(860) 749-6622
Mailing address
233 HAZARD AVE, ENFIELD, CT 06082-4647
(860) 749-6622
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10105
CT
1223P0221X
Pediatric Dentistry
DN1855254
MA
Other
Enumeration date
05/09/2007
Last updated
05/04/2017
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