Organization
LUIKHAM DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE T LUIKHAM DDS (OWNER/DENTIST)
(956) 583-1000
Entity
Organization
Contact information
Practice address
2605 W MILE 5 RD STE 1, MISSION, TX 78574-0968
(956) 583-1000
(956) 583-8000
Mailing address
2605 W MILE 5 RD STE 1, MISSION, TX 78574-0968
(956) 583-1000
(956) 583-8000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
26420
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
294738401
—
TX
Enumeration date
03/16/2015
Last updated
03/16/2015
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