Dr. Kathleen M. Lucking D.D.S.
Dentist in Port Orange, FL(View on Map)
Full Name
Dr. Kathleen Marie Lucking D.D.S.
NPI Number
1912345042
NPI Type
Individual Provider
Gender
Female
Enumeration Date
06/11/2013
Specialties
(Taxonomies)Code
122300000X
390200000X
Primary Taxonomy
Yes
No
Licenses
State
Florida
Illinois
License Number
DN24377
019029445
Contact
Information
Purpose
Mailing
Location
Address
5400 CORACI BLVD APT 6102
5400 CORACI BLVD APT 6102
City
Port Orange
Port Orange
State
FL
FL
Postal Code
32128-7576
32128-7576
Country
US
US
Telephone Number
(989) 708-1384
(989) 708-1384
Identifiers
Identifier
14430849
Identifier State
FL
Identifier Issuer
Unknown
Health Information Exchange
Endpoint Type
DIRECT
Endpoint
kathleen.lucking@pacden.com
Endpoint Description
Unknown
Use
Unknown
Content Type
Unknown
Affiliation
N
Endpoint Location
5400 Coraci Blvd Apt 6102Port Orange, FL321287576US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/27/2021
Provider Address
Other Dentists in Port Orange, Florida:
John Kulaga D.D.S
Port Orange, FLSpecialties: Dentist (Primary)Durable Medical Equipment & Medical Supplies