Provider Demographics
NPI:1780618967
Name:DENUCCI, DONALD J (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:DENUCCI
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 1:10925 CITREON CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2527
Mailing Address - Country:US
Mailing Address - Phone:301-340-0949
Mailing Address - Fax:
Practice Address - Street 1:10925 CITREON CT
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2527
Practice Address - Country:US
Practice Address - Phone:301-340-0949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD112911223P0300X
WI5000760-0151223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics