Individual
PHILLIP NICHOLAS RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10493 FRANKSTOWN ROAD, PITTSBURGH, PA 15235
(412) 371-2442
(412) 371-3892
Mailing address
10493 FRANKSTOWN ROAD, PITTSBURGH, PA 15235
(412) 371-2442
(412) 371-3892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS026260L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185214
BCBS
PA
Enumeration date
10/10/2006
Last updated
07/08/2007
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