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Organization
RICHARD MANCUSO DMD PLLC
Active
Organization
RICHARD MANCUSO DMD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD MANCUSO D.M.D. (MANAGER)
(954) 605-0865
Entity
Organization
Contact information
Practice address
4536 W VILLAGE DR, TAMPA, FL 33624-3429
(954) 605-0865
Mailing address
222 NW 48TH AVE, DEERFIELD BEACH, FL 33442-9308
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20889
FL
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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