Individual
DR. EDWARD RUSSO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5665 FIELDCREST DR, SCOTTSVILLE, VA 24590-3886
(434) 286-3082
(434) 286-3082
Mailing address
5665 FIELDCREST DR, IC, SCOTTSVILLE, VA 24590-3886
(434) 286-3082
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401005184
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008451192
—
VA
Enumeration date
07/17/2006
Last updated
02/08/2017
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