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Organization

4 KIDS DENTAL CENTER, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHRISTOPHER JAMES LUCCY DMD (PRESIDENT)
(724) 837-4400
Entity
Organization

Contact information

Practice address
660 E PITTSBURGH ST, GREENSBURG, PA 15601-2677
(724) 837-4400
(724) 837-1613
Mailing address
660 E PITTSBURGH ST, GREENSBURG, PA 15601-2677
(724) 837-4400
(724) 837-1613

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DS 015320 L
PA
1223P0221X
Pediatric Dentistry
Primary
DS 018180 L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0007813660002
PA
05
0017262150001
PA
Enumeration date
03/20/2008
Last updated
01/29/2015
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