Healthcare Provider Details

I. General information

NPI: 1700703246
Provider Name (Legal Business Name): ALLIES AESTHETICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 NEWBERRY ST NW
AIKEN SC
29801-3929
US

IV. Provider business mailing address

4110 BUFFALO TRL
EVANS GA
30809-0959
US

V. Phone/Fax

Practice location:
  • Phone: 803-649-0044
  • Fax:
Mailing address:
  • Phone: 530-415-9862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLICIA LUCICH
Title or Position: OWNER PROVIDER
Credential: DMD
Phone: 530-415-9862