Organization
LUKE MANCUSO DDS
Active
Other names
Luke Mancuso DDS
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE MANCUSO (DENTIST/OWNER)
(337) 643-6400
Entity
Organization
Contact information
Practice address
1600 W VETERANS MEML DR, KAPLAN, LA 70548-3604
(337) 643-6400
Mailing address
1600 W VETERANS MEML DR, KAPLAN, LA 70548-3604
(337) 643-6400
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447742143
—
LA
05
—
1881906196
—
LA
Enumeration date
10/10/2018
Last updated
10/10/2018
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