Russo, Antonino
Russo, Antonino is an sole proprietor health care provider with primary practice located at 5225 Nesconset Hwy Suite 3, Port Jefferson Station NY 11776-2053. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Russo, Antonino can be contacted via phone (631) 473-6661.Contact Information
Primary practice address
5225 Nesconset Hwy Suite 3
Port Jefferson Station NY 11776-2053
Phone: (631) 473-6661
Fax: (631) 473-6967
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 38381 | New York |
Profile Details
| NPI number | 1497860837 |
|---|---|
| LBN Legal business name | Russo, Antonino |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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