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Individual
DR. LUCIOUS HENRY CLEMONS
Active
Individual
DR. LUCIOUS HENRY CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401003703
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401003703
VIRGINIA STATE BOARD OF DENTISTRY LICENSE
VA
01
—
FORMERLY 54-109-4553
FORMERLY L.HENRY CLEMONS D.D.S. PC ( NO LONGER CORPORATION) AND NO CORP TAX ID
VA
Enumeration date
07/30/2008
Last updated
07/30/2008
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