Individual
LEONARD J FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
44 CENTER ST, PROSPECT, CT 06712-1639
(203) 758-6639
Mailing address
44 CENTER ST, PROSPECT, CT 06712-1639
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7151
CT
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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