Organization
JESSICA RUSSO REVAND, DMD, MS, PLLC
Active
Other names
Russo Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA RUSSO REVAND DMD, MS (OWNER/ENDODONTIST)
(703) 503-0555
Entity
Organization
Contact information
Practice address
8987 HERSAND DR STE 3, BURKE, VA 22015-1604
(703) 503-0555
Mailing address
10603 OLIVER ST, FAIRFAX, VA 22030-3913
(202) 270-4779
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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