Provider Demographics
NPI:1215069984
Name:RAUSCH, LUCIANA C (DMD)
Entity type:Individual
Prefix:DR
First Name:LUCIANA
Middle Name:C
Last Name:RAUSCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 W MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3122
Mailing Address - Country:US
Mailing Address - Phone:203-754-4175
Mailing Address - Fax:203-596-1917
Practice Address - Street 1:1336 W MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3122
Practice Address - Country:US
Practice Address - Phone:203-754-4175
Practice Address - Fax:203-596-1917
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist