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Individual

CRAIG JAMES LUSSIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
500 N. HWY 89, PRESCOTT, AZ 86313
(928) 445-4860
Mailing address
2366 W JAKE HVN, PHOENIX, AZ 85085-7026
(623) 581-5185

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5992
AZ
1223G0001X
General Practice Dentistry
8168
TN

Other

Enumeration date
07/26/2006
Last updated
07/08/2007
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