| Russomanno Keane Dds Pa | |
|
1975 11th Ave E Maplewood MN 55109-5148 | |
| (651) 770-2900 | |
| Not Available |
| Full Name | Russomanno Keane Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1975 11th Ave E, Maplewood, Minnesota |
| Authorized Official Name and Position | Sam Jacobson (BUSINESS MANAGER) |
| Authorized Official Contact | 6513074966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russomanno Keane Dds Pa 8910 Penn Ave S Bloomington MN 55431-2025 Ph: (952) 881-0504 | Russomanno Keane Dds Pa 1975 11th Ave E Maplewood MN 55109-5148 Ph: (651) 770-2900 |
| NPI Number | 1720697808 |
|---|---|
| Provider Enumeration Date | 07/24/2020 |
| Last Update Date | 07/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720697808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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