Individual
DR. JESSICA LUCOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2154 GOODMAN RD W, HORN LAKE, MS 38637-1303
(662) 393-9200
Mailing address
2154 GOODMAN RD W, HORN LAKE, MS 38637-1303
(662) 393-9200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
371313
MS
Other
Enumeration date
06/26/2013
Last updated
08/21/2014
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