| Conrad J Kusel Dds Pa | |
|
491 Sw Port St Lucie Blvd Port St Lucie FL 34953-2044 | |
| (772) 878-7525 | |
| (772) 340-1807 |
| Full Name | Conrad J Kusel Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 491 Sw Port St Lucie Blvd, Port St Lucie, Florida |
| Authorized Official Name and Position | Conrad James Kusel (PRESIDENT) |
| Authorized Official Contact | 7728787525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Conrad J Kusel Dds Pa 491 Sw Port St Lucie Blvd Port St Lucie FL 34953-2044 Ph: (772) 878-7525 | Conrad J Kusel Dds Pa 491 Sw Port St Lucie Blvd Port St Lucie FL 34953-2044 Ph: (772) 878-7525 |
| NPI Number | 1215202502 |
|---|---|
| Provider Enumeration Date | 03/20/2012 |
| Last Update Date | 03/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215202502 | NPI | - | NPPES |
| 1912113606 | Other | FL | GENERAL DENTISTRY |
| 1043426778 | Other | FL | GENRAL DENTISTRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DN-0011106 (Florida) | Primary |
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