# DRS. MANCUSO & MANCUSO P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205127347
- **Authorized official:** DR. GERALD JOHN MANCUSO DDS (VICE PRESIDENT)
- **Authorized official phone:** (402) 397-7799

## Contact information

- **Practice address:** 7930 BLONDO ST, OMAHA, NE 68134-6661
- **Practice address phone:** (402) 397-7799
- **Mailing address:** 7930 BLONDO ST, OMAHA, NE 68134-6661
- **Mailing address phone:** (402) 397-7799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5075 | NE | Yes |

## Other

- **Enumeration date:** 04/24/2011
- **Last updated:** 04/24/2011