Provider Demographics
NPI:1730281858
Name:CUCCIA, STEVEN ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:CUCCIA
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 1:2265 LEWISVILLE-CLEMMONS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012
Mailing Address - Country:US
Mailing Address - Phone:336-766-1366
Mailing Address - Fax:336-766-3163
Practice Address - Street 1:2265 LEWISVILLE-CLEMMONS RD
Practice Address - Street 2:SUITE A
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012
Practice Address - Country:US
Practice Address - Phone:336-766-1366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist