| NPI | 1740442672 |
|---|---|
| Former Name | LISA M DELUCIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055071) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 10032) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2024-07-06 |