MEDICARE: LUCIANA E. BURCA, DDS, PC

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1568550374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCIANA E. BURCA, DDS, PC

Provider Business Mailing Address
First Line	:	5030 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-3244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5030 N MARINE DR
Second Line	:	SUITE 304
City	:	CHICAGO
State	:	IL
Zip	:	60640-3244
Country	:	US
Telephone Number	:	773-447-1021
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUCIANA E SWEIS
Credential	:	DDS
Telephone Number	:	773-506-8052

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	04/03/2012

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