| Lumina Dental Of Lutz, Pa | |
|
2425 Brunello Trce Lutz FL 33558-7800 | |
| (813) 381-5858 | |
| Not Available |
| Full Name | Lumina Dental Of Lutz, Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2425 Brunello Trce, Lutz, Florida |
| Authorized Official Name and Position | John D Ivey (OWNER) |
| Authorized Official Contact | 8133815858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lumina Dental Of Lutz, Pa 2945 Guinevere Dr Titusville FL 32780-5916 Ph: (321) 431-2208 | Lumina Dental Of Lutz, Pa 2425 Brunello Trce Lutz FL 33558-7800 Ph: (813) 381-5858 |
| NPI Number | 1952949141 |
|---|---|
| Provider Enumeration Date | 12/18/2019 |
| Last Update Date | 12/18/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952949141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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