Provider Demographics
NPI:1750508933
Name:LUCIANO, ANTHONY MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:LUCIANO
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 1:50 EASTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1004
Mailing Address - Country:US
Mailing Address - Phone:201-488-1662
Mailing Address - Fax:
Practice Address - Street 1:186 PATERSON AVE
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1837
Practice Address - Country:US
Practice Address - Phone:201-460-0230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist