Individual
DR. LUKE H DERHAKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
11737 S PRESTON HWY, LEBANON JUNCTION, KY 40150-8420
(502) 833-4664
(502) 833-4754
Mailing address
11737 S PRESTON HWY, LEBANON JUNCTION, KY 40150-8420
(502) 833-4664
(502) 833-4754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4935
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60049350
—
KY
Enumeration date
10/04/2005
Last updated
07/09/2007
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