Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ANGELA MICHELLE ILLUZZI-RUSSO, DDS
Active Sole ProprietorDR. ANGELA MICHELLE ILLUZZI-RUSSO, DDS is a Oral & Maxillofacial Surgery healthcare provider located in PORTLAND, Maine. NPI 1811041726 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · PORTLAND, ME
Registration Details
- NPI Number
- 1811041726
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 22, 2007 (19.518193841287 yrs)
- Last Updated
- Feb 4, 2021
- Licenses
-
052809 (NY)22DI02347100 (NJ)DEN4836 (ME)
- Sole Proprietor
- Yes
Practice Information
- Address
-
190 PARK AVEPORTLAND, ME, 041021000Browse ME providers · Browse ZIP 04102
- Phone
- 2078741028
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
- Additional Specialty
- Oral & Maxillofacial Surgery
Other Oral & Maxillofacial Surgery Providers in PORTLAND, ME
| Name | Credential | NPI |
|---|---|---|
| DR. GREGORY V SARKA | DDS,MD | 1043200868 |
| KRISTOPHER COOPER | DMD, MD | 1265814784 |
| ROBERT WALSH | — | 1346745106 |
| DR. MEAGHAN BRADLEY | DMD | 1225533359 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.