Marie Cross Pucillo, D.M.D.

General Practice Dentistry · St Augustine, FL

Individual Active NPI

NPI number 1730428749

Practice location

150 Malaga St
St Augustine, FL 32084-3521
Phone
(904) 829-9024
Fax
(904) 829-3546

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NPI record

NPI
1730428749
Entity type
Individual (Type 1)
Enumeration date
February 11, 2013
Last updated
July 21, 2022
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X DN22667 FL
Student in an Organized Health Care Education/Training Program 390200000X — —

About Dr. Pucillo

Marie Cross Pucillo, D.M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 150 Malaga St, St Augustine, FL 32084-3521. The NPI number 1730428749 was assigned on February 11, 2013 and the record was last updated on July 21, 2022.

Dr. Pucillo lists a license in the registry: #DN22667 (FL) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Marie Cross Pucillo, D.M.D.?

The NPI number is 1730428749.

What is the phone number of Dr. Pucillo?

The phone number listed for the practice location is (904) 829-9024.

Where is Dr. Pucillo located?

150 Malaga St, St Augustine, FL 32084-3521.

What is the taxonomy code for Dr. Pucillo?

The primary taxonomy code is 1223G0001X – General Practice Dentistry; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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