Individual
LUIS FILIPE MARIUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1640 SALEM RD, COOKEVILLE, TN 38506
(931) 400-2442
Mailing address
1640 SALEM RD, COOKEVILLE, TN 38506
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10503
TN
Other
Enumeration date
06/23/2017
Last updated
06/23/2017
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