Individual
STEPHEN J MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2921 13TH STREET, COLUMBUS, NE 68601-4829
(402) 564-7180
(402) 564-7042
Mailing address
2921 13TH STREET, COLUMBUS, NE 68601-4829
(402) 564-7180
(402) 564-7042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5734
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47055108713
—
NE
Enumeration date
08/19/2006
Last updated
07/14/2025
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