Individual
DR. TRAVIS DUANE LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
800 E WAYNE ST, CELINA, OH 45822-1359
(419) 586-1615
Mailing address
PO BOX 316, CELINA, OH 45822-0316
(419) 586-1615
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.020826
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06131
PARAMOUNT
OH
05
—
2057965
—
OH
01
—
9182631
DORAL
OH
Enumeration date
03/23/2007
Last updated
11/04/2020
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