Individual
MRS. JUDITH ELLEN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDA-RDA
Contact information
Practice address
790 RIDGE RD, LACKAWANNA, NY 14218-1629
(716) 823-9352
Mailing address
790 RIDGE RD, LACKAWANNA, NY 14218-1629
(716) 823-9352
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
49000634
NY
Other
Enumeration date
03/19/2010
Last updated
03/19/2010
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