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1063811297
NICHOLAS VITO RUSSO
BROOKFIELD, WI
NPI
1063811297
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: WI 1000994-15)
Enumeration Date
2014-08-13
Last Update Date
2016-02-09
Business Address
Dr. NICHOLAS VITO RUSSO D.D.S.
12690 W NORTH AVE
BROOKFIELD, WI 53005-4636
Phone number: 262-784-3740
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Mailing Address
Dr. NICHOLAS VITO RUSSO D.D.S.
12690 W NORTH AVE
BROOKFIELD, WI 53005-4636
Phone number: 262-784-3740
Copy
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