Cusack, Michael Robert
Cusack, Michael Robert is an individual health care provider with primary practice located at 708 E 20Th St , Farmington NM 87401-4205. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Cusack, Michael Robert can be contacted via phone (505) 327-6155.Contact Information
Primary practice address
708 E 20Th St
Farmington NM 87401-4205
Phone: (505) 327-6155
Fax: (309) 699-7050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 019-027507 | Illinois |
| Dental Providers / General Practice | 1223G0001X | DD3375 | New Mexico |
Profile Details
| NPI number | 1376730200 |
|---|---|
| LBN Legal business name | Cusack, Michael Robert |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2007 |
| Last updated | Mar 14th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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