Organization
MICHAEL A. LUCKETT D.M.D. & ASSOCIATES (RIVERCREST), LTD.
Active
Parent organization
DENTALONE PARTNERS, INC
Other names
DentalWorks
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTALONE PARTNERS, INC
Authorized official
MICHAEL A LUCKETT DMD (DENTIST/OWNER)
(708) 597-9055
Entity
Organization
Contact information
Practice address
4839 WEST CALSAG RD, #310, CRESTWOOD, IL 60445-4415
(708) 597-9055
(216) 584-1062
Mailing address
PO BOX 860036, MINNEAPOLIS, MN 55486
(216) 584-1000
(216) 332-7503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
019.019835
IL
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/27/2006
Last updated
12/08/2016
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