Russo, Peter Anthony

Russo, Peter Anthony is an sole proprietor health care provider with primary practice located at 18800 Main St Ste. 201, Huntington Beach CA 92648-1707. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Russo, Peter Anthony can be contacted via phone (714) 842-2515.

Contact Information

Primary practice address
18800 Main St Ste. 201 Huntington Beach CA 92648-1707
Phone: (714) 842-2515
Fax: (714) 847-7075
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 41127 California

Profile Details

NPI number 1104846849
LBN Legal business name Russo, Peter Anthony
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 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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