Luciano Parker, Joanna Susan

Luciano Parker, Joanna Susan is an individual health care provider with primary practice located at 46 Trifecta Pl Ste 102 , Charles Town WV 25414-4958. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Luciano Parker, Joanna Susan can be contacted via phone (304) 725-0508.

Contact Information

Primary practice address
46 Trifecta Pl Ste 102 Charles Town WV 25414-4958
Phone: (304) 725-0508
Fax: (304) 728-8761
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3708 West Virginia

Profile Details

NPI number 1558581272
LBN Legal business name Luciano Parker, Joanna Susan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2007
Last updated Jan 16th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558581272 NPPES
West Virginia MEDICAID 06586

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