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General NPI Number Information
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NPI Number | 1699345611
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Entity Type | Individual
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Provider Name | PHILIPP LUSCHIN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 09/06/2022
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Provider Practice Location Address
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Address Line | 1405 10TH ST SW
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City | LOVELAND
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State | CO
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Zip | 80537-2301
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Country | US
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Telephone | 970-962-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 10TH ST SW
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City | LOVELAND
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State | CO
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Zip | 80537-2301
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Country | US
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Telephone | 385-202-6114
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Fax |
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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 | 0401417544
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00205043
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License Number State | CO
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