Organization
MAKEMESMILE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY RUSSO DDS (OWNER/OPERATOR)
(917) 796-8612
Entity
Organization
Contact information
Practice address
242 MAIN ST, YARMOUTH, ME 04096-6714
(207) 847-0176
Mailing address
242 MAIN ST, YARMOUTH, ME 04096-6714
(207) 847-0176
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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