Russom, Samuel Yohannes
Russom, Samuel Yohannes is an sole proprietor health care provider with primary practice located at 2015 Birch Rd Ste 103 , Chula Vista CA 91915-2003. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Russom, Samuel Yohannes can be contacted via phone (619) 391-9287.Contact Information
Primary practice address
2015 Birch Rd Ste 103
Chula Vista CA 91915-2003
Phone: (619) 391-9287
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DDS104651 | California |
Profile Details
| NPI number | 1144719196 |
|---|---|
| LBN Legal business name | Russom, Samuel Yohannes |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 4th, 2018 |
| Last updated | Dec 28th, 2021 - about 3 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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