Individual
MR. LAVAL ALONZO LUCAS-PERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
4727 SAINT ANTOINE ST STE 408, DETROIT, MI 48201-1461
(313) 833-7309
Mailing address
4494 WARWICK CIRCLE DR, GRAND BLANC, MI 48439-8337
(810) 691-0245
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902018904
MI
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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