Individual
DR. LUCAS WINEBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2800 COLLEGE AVE, ALTON, IL 62002-4742
(618) 474-7000
Mailing address
2800 COLLEGE AVE, ALTON, IL 62002-4742
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032154
IL
Other
Enumeration date
06/11/2019
Last updated
07/20/2019
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