| NPI | 1952949141 |
|---|---|
| Doing Business As | LUMINA DENTAL OF LUTZ |
| Entity Type | Organization |
| Authorized Contact | JOHN D IVEY Owner 813-381-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |