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General NPI Number Information
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NPI Number | 1265804595
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Entity Type | Individual
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Provider Name | JOY LUCAS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2015
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 9100 FRANKLIN SQUARE DR
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City | ROSEDALE
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State | MD
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Zip | 21237-3903
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Country | US
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Telephone | 410-887-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 614 VALLEY LN
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City | TOWSON
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State | MD
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Zip | 21286-7311
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Country | US
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Telephone | 410-963-5930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11699
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License Number State | MD
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