| Joseph P. Russo, D.D.S. PC | |
|
15 W Water St Wakefield MA 01880-2914 | |
| (781) 245-4400 | |
| (781) 245-4400 |
| Full Name | Joseph P. Russo, D.D.S. PC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 15 W Water St, Wakefield, Massachusetts |
| Authorized Official Name and Position | Joseph P. Russo (OWNER) |
| Authorized Official Contact | 7812454400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph P. Russo, D.D.S. PC 15 W Water St Wakefield MA 01880-2914 Ph: (781) 245-4400 | Joseph P. Russo, D.D.S. PC 15 W Water St Wakefield MA 01880-2914 Ph: (781) 245-4400 |
| NPI Number | 1285783902 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 08/27/2020 |
| Certification Date | 08/27/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285783902 | NPI | - | NPPES |
| XO5115RU | Other | MA | BCBSMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12262 (Massachusetts) | Primary |
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