Organization
LUCCA ORAL AND FACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO LUCCA D.M.D. (OWNER)
(617) 300-0345
Entity
Organization
Contact information
Practice address
185 DARTMOUTH ST, SUITE 403, BOSTON, MA 02116-5883
(617) 300-0345
(617) 993-6970
Mailing address
185 DARTMOUTH ST, SUITE 403, BOSTON, MA 02116-5883
(617) 300-0345
(617) 993-6970
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN20676
MA
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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