Provider Demographics
NPI:1851436513
Name:DULUC, CARLOS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:J
Last Name:DULUC
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 1:37 KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5319
Mailing Address - Country:US
Mailing Address - Phone:845-325-0714
Mailing Address - Fax:845-352-1439
Practice Address - Street 1:66 BEEKMAN AVE FL 1
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-2503
Practice Address - Country:US
Practice Address - Phone:914-366-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0461721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01602717Medicaid