Individual
DR. LUCAS JORDAN DICICCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7055 N FRESNO ST STE 302, FRESNO, CA 93720-2957
(559) 325-3300
Mailing address
11378 N VIA MONTESSORI DR, FRESNO, CA 93730-8839
(559) 451-1873
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
105009
CA
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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