Healthcare Provider Details

I. General information

NPI: 1932169224
Provider Name (Legal Business Name): KAREN K LUCE D.D.S.,M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N. STONEWALL AVE
OKLAHOMA CITY OK
73110
US

IV. Provider business mailing address

1201 N. STONEWALL AVE
OKLAHOMA CITY OK
73117
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8001
  • Fax:
Mailing address:
  • Phone: 405-271-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number62
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: