Healthcare Provider Details

I. General information

NPI: 1619069663
Provider Name (Legal Business Name): FRANCIS J. CUSUMANO D.D.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 PARKWAY OFFICE CT SUITE 200
CARY NC
27518-7428
US

IV. Provider business mailing address

2054 KILDAIRE FARM RD # 425
CARY NC
27518-6614
US

V. Phone/Fax

Practice location:
  • Phone: 919-661-1995
  • Fax: 919-661-8619
Mailing address:
  • Phone: 919-661-1995
  • Fax: 919-861-9718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number7936
License Number StateNC

VIII. Authorized Official

Name: DR. FRANCIS JOSEPH CUSUMANO
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 919-819-4288