Organization
FRED R LUCAS DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED R LUCAS JR. DDS (PRESIDENT)
(580) 623-7397
Entity
Organization
Contact information
Practice address
321 N NASH, WATONGA, OK 73772-0570
(580) 623-7397
(580) 623-4912
Mailing address
PO BOX 570, WATONGA, OK 73772-0570
(580) 623-7397
(580) 623-4912
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/02/2006
Last updated
08/22/2020
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