Organization
DRS. MANCUSO & MANCUSO P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD JOHN MANCUSO DDS (VICE PRESIDENT)
(402) 397-7799
Entity
Organization
Contact information
Practice address
7930 BLONDO ST, OMAHA, NE 68134-6661
(402) 397-7799
Mailing address
7930 BLONDO ST, OMAHA, NE 68134-6661
(402) 397-7799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5075
NE
Other
Enumeration date
04/24/2011
Last updated
04/24/2011
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