Provider Demographics
NPI:1386142420
Name:JOSEPH A. LUCERO D.D.S. INC.
Entity type:Organization
Organization Name:JOSEPH A. LUCERO D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LUCERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-834-0615
Mailing Address - Street 1:2575 PARK LN STE 101
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3336
Mailing Address - Country:US
Mailing Address - Phone:303-834-0615
Mailing Address - Fax:303-284-5579
Practice Address - Street 1:2575 PARK LN
Practice Address - Street 2:101
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3336
Practice Address - Country:US
Practice Address - Phone:303-834-0615
Practice Address - Fax:303-284-5579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-23
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002031721223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty