Individual
DR. GLENN WALTON DELUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8 EAST CORTELYOU ST, HUNTINGTON STATION, NY 11746
(631) 365-7640
Mailing address
8 EAST CORTELYOU ST, HUNTINGTON STATION, NY 11746
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0299771
NY
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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