| James C. Fusco, D.d.s., P.c. | |
|
303 Spring St Hermitage MO 65668-0105 | |
| (417) 745-2134 | |
| (417) 745-2135 |
| Full Name | James C. Fusco, D.d.s., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 303 Spring St, Hermitage, Missouri |
| Authorized Official Name and Position | James C Fusco (DENTIST/OWNER) |
| Authorized Official Contact | 4177452134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James C. Fusco, D.d.s., P.c. Po Box 105 Hermitage MO 65668-0105 Ph: (417) 745-2134 | James C. Fusco, D.d.s., P.c. 303 Spring St Hermitage MO 65668-0105 Ph: (417) 745-2134 |
| NPI Number | 1275707135 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275707135 | NPI | - | NPPES |
| 406679209 | Medicaid | MO | |
| 187734 | Other | MO | DORAL DENTAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DE015502 (Missouri) | Primary |