Individual
DR. PETER DAVID RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
53 MONTOWESE ST, BRANFORD, CT 06405
(203) 483-1816
(203) 483-1160
Mailing address
53 MONTOWESE ST, BRANFORD, CT 06405
(203) 483-1816
(203) 483-1160
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6739
CT
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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