Individual
DR. LUCAS CHARLES DEETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1003 GATEWAY AVE, BISMARCK, ND 58503-0508
(701) 222-1800
Mailing address
623 RAYMOND ST, BISMARCK, ND 58501-3440
(414) 477-9642
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223G0001X
ND
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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