Individual
MARIA MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11714 SW WESTCLIFFE LN, PORT ST LUCIE, FL 34987-2106
(631) 278-3397
Mailing address
11714 SW WESTCLIFFE LN, PORT ST LUCIE, FL 34987-2106
(631) 278-3397
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
017103-01
NY
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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