Organization
JUANA E LUSTER DDS PC
Active
Parent organization
JUANA E LUSTER DDS PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JUANA E LUSTER DDS PC
Authorized official
JUANA E LUSTER DDS (OWNER)
(718) 339-3358
Entity
Organization
Contact information
Practice address
1376 EAST 15 ST, BKLYN, NY 11230
(718) 339-3358
(718) 339-3358
Mailing address
1376 EAST 15 ST, BKLYN, NY 11230
(718) 339-3358
(718) 339-3358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0462051
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01668482
—
NY
Enumeration date
05/15/2008
Last updated
05/15/2008
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