Individual
LUCAS IAN TROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
210 W HARRISON ST, MONTICELLO, IN 47960-2208
(574) 583-8060
Mailing address
210 W HARRISON ST, MONTICELLO, IN 47960-2208
(574) 583-8060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013348A
IN
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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