Individual
LOUIS ROBERT PRUSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
57 STREET RD, SOUTHAMPTON, PA 18966-3100
(215) 355-3513
(215) 355-3513
Mailing address
57 STREET RD, SOUTHAMPTON, PA 18966-3100
(215) 355-3513
(215) 355-3513
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DS016805L
PA
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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