Organization
STACY Z. LUKANUSKI DDS PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY LUKANUSKI D.D.S. (DDS)
(804) 264-9460
Entity
Organization
Contact information
Practice address
2105 E PARHAM RD, SUITE 107, RICHMOND, VA 23228-2236
(804) 264-9460
(804) 264-9462
Mailing address
2105 E PARHAM RD, SUITE 107, RICHMOND, VA 23228-2236
(804) 264-9460
(804) 264-9462
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008884
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
981168
UNITED CONCORDIA
—
Enumeration date
10/24/2007
Last updated
04/20/2008
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