Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Marie Cross Pucillo, DMD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1730428749

Dr. Marie Cross Pucillo, DMD is a Student in an Organized Health Care Education/Training Program in St Augustine, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2013
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

150 Malaga St
St Augustine, FL 32084-3521
Phone: (904) 829-9024
Fax: (904) 829-3546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DN22667 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1730428749
Entity typeIndividual (Type 1)
GenderFemale
Credentials DMD
Sole proprietorYes
NPI enumeratedFebruary 11, 2013
Last updated in NPPESJuly 21, 2022
Mailing address150 Malaga St, St Augustine, FL 32084-3521

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