Provider Demographics
NPI:1568578649
Name:DELUCA, FRANK PETER (DDS)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:PETER
Last Name:DELUCA
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 1:7952 STARBURST DR
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3036
Mailing Address - Country:US
Mailing Address - Phone:410-484-5166
Mailing Address - Fax:410-484-5166
Practice Address - Street 1:40 S DUNDALK AVE
Practice Address - Street 2:303
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4267
Practice Address - Country:US
Practice Address - Phone:410-284-9228
Practice Address - Fax:410-284-9336
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4149122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist