Organization
JOHN E. RUSSO, D.M.D, P.A.
Active
Other names
John E. Russo, D.M.D. Family and Cosmetic Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA ROCHA (SR TEAM LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
430 N MILLS AVE STE 3, ORLANDO, FL 32803-5746
(407) 843-2112
Mailing address
430 N MILLS AVE STE 3, ORLANDO, FL 32803-5746
(407) 843-2112
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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