Provider Demographics
NPI:1427465178
Name:LUCERO, JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:LUCERO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND134601223P0700X
CO002031721223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty