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Dr. Marie Cross Pucillo, DMD
General Practice Dentistry in St Augustine, Florida
NPI 1730428749

Marie Cross Pucillo is a General Practice Dentistry based in St Augustine, FL and is specialized in General Practice. Marie Cross Pucillo practices in St Augustine, FL and has the professional credentials of DMD. The NPI Number for Marie Cross Pucillo is 1730428749 and holds a License No. (Florida).

The current practice location address for Marie Cross Pucillo is 150 Malaga St, St Augustine, FL and can be reached out via phone at 904-829-9024 and via fax at 904-829-3546.

Location: 150 Malaga St, St Augustine, FL, 32084-3521
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730428749
Provider Name
Marie Cross Pucillo
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
150 Malaga St, St Augustine, FL, 32084-3521
Phone Number
904-829-9024
Fax Number
904-829-3546
Provider Enumeration Date
02/11/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
150 Malaga St
City
St Augustine
State
Florida
Zip
32084-3521
Phone Number
904-829-9024
Fax Number
904-829-3546
person
Provider Business Mailing Address Details
Address
150 Malaga St
City
St Augustine
State
Florida
Zip
32084-3521
Phone Number
904-829-9024
Fax Number
904-829-3546
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DN22667 (Florida)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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