MEDICARE: DEBI LUX DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13501	FL

General Provider Information

NPI Number	:	1285015198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBI LUX DDS

Provider Business Mailing Address
First Line	:	3411 TAMIAMI TRL N
Second Line	:	SUITE 200
City	:	NAPLES
State	:	FL
Zip	:	34103-3700
Country	:	US
Telephone Number	:	239-300-6598
Fax Number	:

Provider Business Practice Location Address
First Line	:	3411 TAMIAMI TRL N
Second Line	:	SUITE 200
City	:	NAPLES
State	:	FL
Zip	:	34103-3700
Country	:	US
Telephone Number	:	239-300-6598
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2015
Last Update Date	:	06/16/2015

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