Provider Demographics
NPI:1033253448
Name:CUOMO, GERARD MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:MICHAEL
Last Name:CUOMO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17756 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2211
Mailing Address - Country:US
Mailing Address - Phone:561-995-0790
Mailing Address - Fax:561-995-1939
Practice Address - Street 1:900 NW 13TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2335
Practice Address - Country:US
Practice Address - Phone:561-391-6290
Practice Address - Fax:561-391-6299
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 100191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice