Individual
JONATHAN THACHARA LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
26220 POINT LOOKOUT RD, LEONARDTOWN, MD 20650-3748
(301) 475-8100
Mailing address
PO BOX 477, 26220 POINT LOOKOUT ROAD, LEONARDTOWN, MD 20650-2158
(301) 475-8100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16580
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS042595
PA
Other
Enumeration date
04/07/2018
Last updated
06/24/2020
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