Individual
DR. FRANK RUSSOMANNO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8910 PENN AVE S, BLOOMINGTON, MN 55431-2025
(952) 881-0504
(952) 884-0188
Mailing address
1423 KINGSWOOD PONDS RD, EAGAN, MN 55122-2878
(952) 484-8703
(952) 884-0188
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11333
MN
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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