Individual
DR. VANESSA LYNN MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
1312 E BROWARD BLVD, FORT LAUDERDALE, FL 33301-2136
(786) 449-4262
Mailing address
1312 E BROWARD BLVD, FORT LAUDERDALE, FL 33301-2136
(786) 449-4262
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN25475
FL
Other
Enumeration date
09/09/2020
Last updated
04/26/2024
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