# JOHN LUCIANI DMD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568175875
- **Authorized official:** DR. JOHN JOSEPH LUCIANI III DMD (OWNER)
- **Authorized official phone:** (717) 818-4059

## Contact information

- **Practice address:** 516 GREEN LN, PHILADELPHIA, PA 19128-2619
- **Practice address phone:** (215) 482-4250
- **Practice address fax:** (215) 428-4250
- **Mailing address:** 516 GREEN LN, PHILADELPHIA, PA 19128-2619
- **Mailing address phone:** (215) 482-4250
- **Mailing address fax:** (215) 428-4250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/02/2023
- **Last updated:** 01/02/2023