Russo, Wynn Christopher

Russo, Wynn Christopher is an individual health care provider with primary practice located at 2301 Williams Blvd , Kenner LA 70062-5721. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Russo, Wynn Christopher can be contacted via phone (504) 887-7811.

Contact Information

Primary practice address
2301 Williams Blvd Kenner LA 70062-5721
Phone: (504) 887-7811
Fax: (504) 469-5181
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 4223 Louisiana

Profile Details

NPI number 1881656403
LBN Legal business name Russo, Wynn Christopher
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881656403 NPPES
Louisiana MEDICAID 1842231
Louisiana Other A-2040

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