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NPI Code Detail

MEDICARE: STEVEN CHARLES TUCKER DDS

MEDICARE:   STEVEN CHARLES TUCKER  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryCO05488CO

General Provider Information

NPI Number : 1952487126
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN CHARLES TUCKER DDS
Provider Business Mailing Address
First Line : 1103 OAK PARK DR
Second Line :
City : FT COLLINS
State : CO
Zip : 80525-6273
Country : US
Telephone Number : 970-223-2882
Fax Number : 970-223-4944
Provider Business Practice Location Address
First Line : 1103 OAK PARK DR
Second Line :
City : FT COLLINS
State : CO
Zip : 80525-6273
Country : US
Telephone Number : 970-223-2882
Fax Number : 970-223-4944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 07/08/2007

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Directions to “ STEVEN CHARLES TUCKER DDS” Practice Location

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