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Individual
DR. EDWARD E. LUCAS
Active
Individual
DR. EDWARD E. LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN007894
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000150323A
—
GA
01
—
000150323B
MEDICAID
GA
Enumeration date
03/30/2007
Last updated
01/20/2024
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