Individual
JOSEPH RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
47 WILLIAM ST, LYONS, NY 14489-1544
(315) 946-6511
Mailing address
47 WILLIAM ST, LYONS, NY 14489-1544
(315) 946-6511
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
057342
NY
Other
Enumeration date
05/05/2013
Last updated
10/16/2018
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