Provider Demographics
NPI:1821480930
Name:RUSSELL S. POLLINA DDS PC
Entity Type:Organization
Organization Name:RUSSELL S. POLLINA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-382-1720
Mailing Address - Street 1:18 E DUNDEE RD.
Mailing Address - Street 2:BLDG 5 STE 100
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5238
Mailing Address - Country:US
Mailing Address - Phone:847-382-1720
Mailing Address - Fax:
Practice Address - Street 1:18 E DUNDEE RD
Practice Address - Street 2:BLDG 5 STE 100
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5238
Practice Address - Country:US
Practice Address - Phone:847-382-1720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0210016741223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty