Provider Demographics
NPI:1972511913
Name:LUCCHESE, JOHN V (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:V
Last Name:LUCCHESE
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 1:2835 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1913
Mailing Address - Country:US
Mailing Address - Phone:716-875-1600
Mailing Address - Fax:716-892-5055
Practice Address - Street 1:2835 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14227-1913
Practice Address - Country:US
Practice Address - Phone:716-875-1600
Practice Address - Fax:716-892-5055
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist