SAMUEL YOHANNES RUSSOM

CHULA VISTA, CA
NPI1144719196
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0221X Dentist Pediatric Dentistry
(Licence: CA  DDS104651)
Enumeration Date2018-05-04
Last Update Date2021-12-28
Business Address
DR. SAMUEL YOHANNES RUSSOM DDS
2015 BIRCH RD STE 103
CHULA VISTA, CA 91915-2003
Phone number: 619-391-9287
Mailing Address
DR. SAMUEL YOHANNES RUSSOM DDS
5311 OAK PARK DR
SAN DIEGO, CA 92105-4959
Phone number: 619-263-0384
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