Russo, Mary Kathleen
Russo, Mary Kathleen is an individual health care provider with primary practice located at 804 Highway 71 , Sea Girt NJ 08750-2807. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Russo, Mary Kathleen can be contacted via phone (732) 449-6564.Contact Information
Primary practice address
804 Highway 71
Sea Girt NJ 08750-2807
Phone: (732) 449-6564
Fax: (732) 449-8606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 22DI02293800 | New Jersey |
Profile Details
| NPI number | 1710030234 |
|---|---|
| LBN Legal business name | Russo, Mary Kathleen |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jul 10th, 2015 - about 9 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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