Organization
FRANK RUSSOMANNO, JR, DDS, P.A.
Active
Other names
Amber Leaf Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK RUSSOMANNO JR. DDS (OWNER)
(952) 881-0504
Entity
Organization
Contact information
Practice address
8910 PENN AVE S, BLOOMINGTON, MN 55431-2025
(952) 881-0504
(952) 884-0188
Mailing address
8910 PENN AVE S, BLOOMINGTON, MN 55431-2025
(952) 881-0504
(952) 884-0188
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11333
MN
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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