Provider Demographics
NPI:1316052962
Name:CUSUMANO, FRANCIS JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:JOSEPH
Last Name:CUSUMANO
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:2054 KILDAIRE FARM RD
Mailing Address - Street 2:MAILBOX #218
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6614
Mailing Address - Country:US
Mailing Address - Phone:919-661-1995
Mailing Address - Fax:866-885-5295
Practice Address - Street 1:5638 NC HIGHWAY 42 W
Practice Address - Street 2:SUITE 111
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-7998
Practice Address - Country:US
Practice Address - Phone:919-661-1995
Practice Address - Fax:866-885-5295
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC79361223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5902316Medicaid