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General NPI Number Information
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NPI Number | 1386142420
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Entity Type | Organization
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Legal Business Name | JOSEPH A. LUCERO D.D.S. INC.
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Dates
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Enumeration Date | 01/23/2018
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 2575 PARK LN 101
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City | LAFAYETTE
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State | CO
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Zip | 80026-3336
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Country | US
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Telephone | 303-834-0615
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Fax | 303-284-5579
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Provider Business Mailing Address
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Address Line | 2575 PARK LN STE 101
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City | LAFAYETTE
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State | CO
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Zip | 80026-3336
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Country | US
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Telephone | 303-834-0615
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Fax | 303-284-5579
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH ANDREW LUCERO
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Credential | DDS
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Telephone | 303-834-0615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 00203172
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License Number State | CO
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