Whalio Doctors

NPI 1043316698

Mary T Mancuso, DMD

Practitioner General Practice Dentistry Fair Lawn, NJ

Practice location

Address
27-11 Pellack Dr, Fair Lawn, NJ 07410-3723
Phone
(201) 796-7171
Fax
(201) 796-0600
Mailing address
167 Glenwood Dr, North Haledon, NJ 07508-3020

Registered specialties

General Practice Dentistry Primary
Dental Providers Taxonomy 1223G0001X Licence 17835 (NJ)

Registry record

NPI
1043316698
Entity type
Individual
Sex (as registered)
Female
NPI issued
14 Sep 2006
Record last updated
8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.