Individual provider · Type 1 NPI

Peter Anthony Russo, DDS

Periodontics · Huntington Beach, CA

NPI number 1104846849 Active

Practice location

18800 Main St, Ste. 201
Huntington Beach, CA 92648-1707

Call (714) 842-2515 Map

Fax (714) 847-7075

Specialties and licenses

TaxonomyCodeLicense
Periodontics Primary 1223P0300X41127 (CA)

Periodontics: 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 structures and tissues.

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About NPI 1104846849

Peter Anthony Russo, DDS's National Provider Identifier is 1104846849, issued on Jul 19, 2006. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Huntington Beach, CA. The record was last updated on Jul 8, 2007.