Individual
LUCAS MARZULLO MENDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5201 BOSQUE BLVD STE 200, WACO, TX 76710-4676
(254) 261-6363
Mailing address
5201 BOSQUE BLVD STE 200, WACO, TX 76710-4676
(254) 261-6363
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
0401419719
VA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
42145
TX
Other
Enumeration date
09/17/2025
Last updated
02/09/2026
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