Individual
ANTHONY JOE FUSCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3463 US-21, SUITE 101, FORT MILL, SC 29715
(704) 825-2081
Mailing address
3463 US-21, SUITE 101, FORT MILL, SC 29715
(704) 825-2081
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DE61295237
WA
1223G0001X
General Practice Dentistry
Primary
10702
SC
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/27/2021
Last updated
05/21/2024
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