| NPI | 1285377812 |
|---|---|
| Doing Business As | RUSSELL STREET DENTAL ASSOCIATION |
| Entity Type | Organization |
| Authorized Contact | AIMEE HODGERNEY Credentialing 508-589-8270 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-04-20 |