Provider Demographics
NPI:1891876322
Name:CUCURAS, JOHN NICHOLAS
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NICHOLAS
Last Name:CUCURAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 S TRIMBLE RD
Mailing Address - Street 2:STE A
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906
Mailing Address - Country:US
Mailing Address - Phone:419-756-0321
Mailing Address - Fax:419-756-4430
Practice Address - Street 1:564 S TRIMBLE RD
Practice Address - Street 2:STE A
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906
Practice Address - Country:US
Practice Address - Phone:419-756-0321
Practice Address - Fax:419-756-4430
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18494122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist