CONRAD J KUSEL DDS PA
Dentist at Port St Lucie Blvd, Fort Pierce, FL

License number
Florida DN-0011106
Category
Dentist
Type
General Practice
Owner
Name: DR. CONRAD JAMES KUSEL JR. DDS
Title: PRESIDENT
Phone: (772) 878-7525
Address
Address
491 SW Port St Lucie Blvd, Fort Pierce, FL 34953
National Provider ID: 1215202502
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DR. CONRAD J. KUSEL, PA

491 Prt St Lucie Blvd, Port Saint Lucie, FL 34953

Status:
Inactive
Doing business as:
Dr. Conrad J. Kusel, D.D.S., PA<br>Kusel & Kusel Family Dentistry
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Sep 8, 1970
Inactive since:
Aug 30, 2007
Phone:
(772) 878-7525 (Phone), (772) 340-1806 (Fax)
State ID:
602380
Business type:
Florida Profit Corporation
President, Managers:
Brian Kusel, 491 SE Prt Saint Lucie Blvd, Port Saint Lucie, FL 34953 (Physical),Brian M Kusel (Vice President, Secretary, President), 2718 SE Eagle Dr, Port Saint Lucie, FL 34984 (Physical),Deborah Kusel (Business Manager),...
EIN:
59-1304591

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