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Provider Information for 1538214945



ANTHONY DELUCIA DDS

Gender: MALE

Individual NPI: 1538214945

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1538214945
Enumeration Date 2007-01-24
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 731 COLORADO AVE
STUART, FL 34994-3017
United States

Phone: 772-287-7077 | Fax: 772-220-4702
View Map External Link
Primary Practice Address 731 COLORADO AVE
STUART, FL 34994-3017
United States

Phone: 772-287-7077 | Fax: 772-220-4702
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice FL DN0011246