Individual
DOMINIC REESE MUCCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2111 BELCOURT AVE STE 201, NASHVILLE, TN 37212-3540
(615) 322-2377
Mailing address
401 32ND AVE S APT A, NASHVILLE, TN 37212-3209
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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