Organization
GRAND LAKE FAMILY DENTISTRY TRAVIS D LUTZ DDS- ROCKFORD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS LUTZ DDS (OWNER/DENTIST)
(419) 305-9983
Entity
Organization
Contact information
Practice address
160 E. WALNUT ST., ROCKFORD, OH 45882
(419) 363-3537
Mailing address
160 E. WALNUT ST., ROCKFORD, OH 45882
(419) 363-3537
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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