Provider Demographics
NPI:1891853511
Name:DUILIO A STRICCA DDS PC
Entity Type:Organization
Organization Name:DUILIO A STRICCA DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DUILIO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:STRICCA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:709-543-2604
Mailing Address - Street 1:753 WEST ABRIENDO AVENUE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004
Mailing Address - Country:US
Mailing Address - Phone:719-543-2604
Mailing Address - Fax:719-543-2605
Practice Address - Street 1:753 WEST ABRIENDO AVENUE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004
Practice Address - Country:US
Practice Address - Phone:719-543-2604
Practice Address - Fax:719-543-2605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty