Dr. Nicholas V. Russo D.D.S.
Dentist in Brookfield, WI(View on Map)
Full Name
Dr. Nicholas Vito Russo D.D.S.
NPI Number
1063811297
NPI Type
Individual Provider
Gender
Male
Enumeration Date
08/13/2014
Specialties
(Taxonomies)Licenses
State
Wisconsin
License Number
1000994-15
Contact
Information
Purpose
Mailing
Location
Address
12690 W NORTH AVE
12690 W NORTH AVE
City
Brookfield
Brookfield
State
WI
WI
Postal Code
53005-4636
53005-4636
Country
US
US
Telephone Number
(262) 784-3740
(262) 784-3740
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/09/2016
Provider Address
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