| NPI | 1952796658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS R LUCAS Owner 239-262-5851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |