Individual
DR. MICHAEL JOSEPH CUSUMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4350 FAIRFAX DR STE 135, ARLINGTON, VA 22203-1636
(703) 525-4071
(703) 525-0868
Mailing address
4350 FAIRFAX DR STE 135, ARLINGTON, VA 22203-1636
(703) 525-4071
(703) 525-0868
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416110
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401416110
STATE OF VIRIGNIA
VA
Enumeration date
07/02/2018
Last updated
06/11/2019
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