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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