Individual
DR. JOHN N RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
300 FOULK RD, WILMINGTON, DE 19803-3886
(302) 652-3775
Mailing address
300 FOULK RD, WILMINGTON, DE 19803-3886
(302) 652-3775
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
GI 0000719
DE
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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