Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730428749 Individual Practitioner Female Practitioner

Dr. Marie Cross Pucillo , DMD

Dentist - General Practice • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Dr. Marie Pucillo, DMD is a registered healthcare professional specializing in Dentist - General Practice in St Augustine, FL. Practice services are available at 150 MALAGA ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

150 Malaga St

St Augustine, FL 320843521

Telephone 9048299024
Fax 9048293546
Associated Practice Facility / Clinic
🏢 Smile So Big Flagler Pllc Facility NPI 1942021514

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
44 Specialists

Practicing in St Augustine, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN22667

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Alex Joseph Rustia , DMD

Dentist - General Practice

NPI 1194554535

Doctor of Dental Medicine

NPI 1972789725

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 21, 2022

Student in an Organized Health Care Education/Training Program

NPI Profile Active September 14, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 14, 2017

Registered at 150 MALAGA ST, ST AUGUSTINE, FL 320843521 (Tel: 9048299024)

📍
Updated Business Mailing Address September 14, 2017

Registered at 150 MALAGA ST, ST AUGUSTINE, FL 320843521 (Tel: (904) 829-9024)

👤
Provider Name / Credentials Updated September 14, 2017

Recorded as MARIE PUCILLO, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2017

Dentist (License #DN22667 in FL)

NPI Profile Active February 11, 2013

NPI status registered as active in NPPES database

📍
Updated Practice Location February 11, 2013

Registered at 1 ASTON PL, CHARLESTON, SC 294011344 (Tel: 8039201011)

📍
Updated Business Mailing Address February 11, 2013

Registered at 1 ASTON PL, CHARLESTON, SC 294011344 (Tel: 8039201011)

👤
Provider Name / Credentials Updated February 11, 2013

Recorded as MARIE CROSS, D.M.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 11, 2013

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration February 11, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730428749
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 11, 2013
Last Update: July 21, 2022
Sole Proprietor: Yes

Mailing Address

150 Malaga St

St Augustine, FL 320843521

Phone: 9048299024

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.