| NPI | 1568662880 |
|---|---|
| Professional Name | GUS S RUSSO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PA DS019052L) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2007-07-24 |