MEDICARE: DR. LUCAS J HEMANN 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	1223G0001X	General Practice Dentistry	08947	IA

General Provider Information

NPI Number	:	1508112244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUCAS J HEMANN DDS

Provider Business Mailing Address
First Line	:	3455 STONEMAN RD
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52002-5292
Country	:	US
Telephone Number	:	563-556-3213
Fax Number	:	563-556-5253

Provider Business Practice Location Address
First Line	:	3455 STONEMAN RD
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52002-5292
Country	:	US
Telephone Number	:	563-556-3213
Fax Number	:	563-556-5253

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

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	07/31/2012

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