Individual
DR. VINCENT W MANCUSO JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 73RD ST, SUITE 10, WINDSOR HEIGHTS, IA 50311-1321
(515) 223-1298
(515) 223-1959
Mailing address
1000 73RD ST, SUITE 10, WINDSOR HEIGHTS, IA 50311-1321
(515) 223-1298
(515) 223-1959
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5809
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0038372
—
IA
Enumeration date
03/28/2006
Last updated
07/08/2007
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