Peter Anthony Russo in Huntington Beach - Periodontics
Peter Anthony Russo - NPI 1104846849
Peter Anthony Russo is a Periodontics in Huntington Beach, California. Peter Anthony Russo practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Peter Anthony Russo is 1104846849. The last update date is 2007-07-08.
Peter Anthony Russo's current location address is 18800 Main St, Huntington Beach, California. You can contact this provider via phone number 7148422515 and fax number 7148477075. The mailing address for Peter Anthony Russo is 18800 Main St, Huntington Beach, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Peter Anthony Russo |
|---|---|
| Address | 18800 Main St, Huntington Beach, California |
| Phone Number | 7148422515 |
| Fax Number | 7148477075 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1104846849 |
|---|---|
| Provider Enumeration Date | 2006-07-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 18800 Main St |
|---|---|
| City | Huntington Beach |
| State | California (CA) |
| Post Code | 926481707 |
| Phone Number | 7148422515 |
| Fax Number | 7148477075 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 41127 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the unique identification code assigned to Peter Anthony Russo by the Centers for Medicare & Medicaid Services?
The Peter Anthony Russo has been issued the NPI (National Provider Identifier) 1104846849. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Peter Anthony Russo?
The Peter Anthony Russo is physically situated at 18800 Main St, in the city of Huntington Beach, state of CA, with the postal code 926481707.
What is the Peter Anthony Russo's area of specialization and corresponding taxonomy classification?
The Peter Anthony Russo's specialty field is Periodontics, and it falls under the taxonomy code 1223P0300X, which categorizes healthcare providers based on their specialties.
On what date did the Peter Anthony Russo receive the assignment of its 1104846849 from the Centers for Medicare & Medicaid Services?
The Peter Anthony Russo was issued its 1104846849 by the Centers for Medicare & Medicaid Services on 2006-07-19.
As of what date were the details related to Peter Anthony Russo most recently updated or revised?
The information pertaining to Peter Anthony Russo, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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