| Garrett Russikoff D.m.d., Inc. | |
|
18911 Nordhoff St Ste 35 Northridge CA 91324-3784 | |
| (818) 701-5126 | |
| Not Available |
| Full Name | Garrett Russikoff D.m.d., Inc. |
|---|---|
| Speciality | Dentist |
| Location | 18911 Nordhoff St Ste 35, Northridge, California |
| Authorized Official Name and Position | Garrett Russikoff (PRESIDET/ CEO) |
| Authorized Official Contact | 8187015126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garrett Russikoff D.m.d., Inc. 18911 Nordhoff St Ste 35 Northridge CA 91324-3784 Ph: (818) 701-5126 | Garrett Russikoff D.m.d., Inc. 18911 Nordhoff St Ste 35 Northridge CA 91324-3784 Ph: (818) 701-5126 |
| NPI Number | 1124599006 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124599006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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