Organization
JAMES C. FUSCO, D.D.S., P.C.
Active
Other names
Hermitage Dental Cener
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES C FUSCO D.D.S. (DENTIST/OWNER)
(417) 745-2134
Entity
Organization
Contact information
Practice address
303 SPRING ST, HERMITAGE, MO 65668-0105
(417) 745-2134
(417) 745-2135
Mailing address
PO BOX 105, HERMITAGE, MO 65668-0105
(417) 745-2134
(417) 745-2135
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE015502
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187734
DORAL DENTAL
MO
05
—
406679209
—
MO
Enumeration date
04/22/2008
Last updated
04/22/2008
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