Provider Demographics
NPI:1699736207
Name:VALUCK, PAUL E (DDS)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:E
Last Name:VALUCK
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 1:6825 E TENNESSEE AVE
Mailing Address - Street 2:#515
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1628
Mailing Address - Country:US
Mailing Address - Phone:303-331-1650
Mailing Address - Fax:303-331-1652
Practice Address - Street 1:6825 E TENNESSEE AVE
Practice Address - Street 2:#515
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1628
Practice Address - Country:US
Practice Address - Phone:303-331-1650
Practice Address - Fax:303-331-1652
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1059471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice