Individual
DR. LUKE MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4906 AMBASSADOR CAFFERY PKWY, BLDG I, LAFAYETTE, LA 70508-6962
(337) 456-5573
Mailing address
11 MARQUIS MNR, MORGAN CITY, LA 70380-1152
(225) 978-8603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6060
LA
Other
Enumeration date
07/02/2010
Last updated
10/20/2010
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