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Contact Information

EDWARD N RUSSO, DMD
2171 JERICHO TURNPIKE
SUITE # 145
COMMACK, NY11725
 Phone: 631-462-6888
 Fax: 631-499-0775
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for EDWARD N RUSSO · (Male)

NPI # 1003954215
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 02/01/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 040596
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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