Provider Demographics
NPI:1679701734
Name:DERESCIUC, VLADIMIR (DMD)
Entity type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:DERESCIUC
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SMILE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806
Mailing Address - Country:US
Mailing Address - Phone:828-693-7533
Mailing Address - Fax:
Practice Address - Street 1:4 SMILE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:US
Practice Address - Phone:828-693-7533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037963122300000X
GADN015804122300000X
NC12191122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist