Individual
DR. BRYAN JAMES MICUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
704 LINCOLN AVE, PITTSBURGH, PA 15202-3407
(412) 761-0202
(412) 761-0372
Mailing address
704 LINCOLN AVE, PITTSBURGH, PA 15202-3407
(412) 761-0202
(412) 761-0372
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DSO28123-L
PA
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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