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General NPI Number Information
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NPI Number | 1144578048
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Entity Type | Individual
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Provider Name | LINDA DIANE PAULETTE DE LUCA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 700 BROADWAY STE 64
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City | WESTWOOD
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State | NJ
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Zip | 07675-1674
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Country | US
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Telephone | 201-666-1300
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Fax | 210-666-2055
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Provider Business Mailing Address
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Address Line | 700 BROADWAY STE 64
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City | WESTWOOD
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State | NJ
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Zip | 07675-1674
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Country | US
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Telephone | 201-666-1300
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Fax | 201-666-2055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D102121900
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License Number State | NJ
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