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:
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Health care specialties

SpecialtyCodeLicense #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 3 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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