| Robert M Lucero | |
|
668 E 12225 S Suite 101 Draper UT 84020-8340 | |
| (801) 553-9824 | |
| (801) 553-0471 |
| Full Name | Robert M Lucero |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 668 E 12225 S, Draper, Utah |
| Authorized Official Name and Position | Robert M Lucero (OWNER PRESIDENT) |
| Authorized Official Contact | 8015539824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert M Lucero 668 E 12225 S Suite 101 Draper UT 84020-8340 Ph: (801) 553-9824 | Robert M Lucero 668 E 12225 S Suite 101 Draper UT 84020-8340 Ph: (801) 553-9824 |
| NPI Number | 1922018050 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 04/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922018050 | NPI | - | NPPES |
| 783866 | Other | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 279701-9922 (Utah) | Primary |
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