Individual
MIGUEL ANGEL JUSINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
28901 TRAILS EDGE BLVD STE 103, BONITA SPRINGS, FL 34134-7588
(239) 913-6780
(239) 301-2611
Mailing address
6841 LIVINGSTON WOODS LN, NAPLES, FL 34109-3835
(787) 431-7479
(239) 301-2611
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2824
PR
1223P0300X
Periodontics
125980
PR
1223P0300X
Periodontics
Primary
DN23154
FL
Other
Enumeration date
09/29/2008
Last updated
12/17/2019
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