Individual
DR. GERALD JOHN MANCUSO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7930 BLONDO ST, OMAHA, NE 68134-6661
(402) 397-7799
Mailing address
7930 BLONDO ST, OMAHA, NE 68134-6661
(402) 397-7799
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5075
NE
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
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