Individual
ELLIOT LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15910 71ST AVE APT 3H, FRESH MEADOWS, NY 11365-3024
(347) 244-2914
Mailing address
15910 71ST AVE APT 3H, FRESH MEADOWS, NY 11365-3024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
057524
NY
Other
Enumeration date
08/15/2014
Last updated
08/15/2014
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