Organization
LUCERO DDS INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORLANDO JUAN LUCERO DDS (OWNER)
(719) 599-5980
Entity
Organization
Contact information
Practice address
1855 AUSTIN BLUFFS PKWY, COLORADO SPRINGS, CO 80918-7880
(719) 599-5980
(719) 599-0691
Mailing address
1855 AUSTIN BLUFFS PKWY, COLORADO SPRINGS, CO 80918-7880
(719) 599-5980
(719) 599-0691
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
80
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02000800
—
CO
05
—
02072908
—
CO
05
—
04017570
—
CO
Enumeration date
09/27/2011
Last updated
09/27/2011
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