Provider Demographics
NPI:1164650313
Name:LUCACI, PATRICK (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:LUCACI
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S. SANTE FE AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-829-8200
Mailing Address - Fax:480-287-8296
Practice Address - Street 1:200 S. SANTE FE AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-829-8200
Practice Address - Fax:480-287-8296
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009015913122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist