Individual
DR. TIMOTHY JOHN LUTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3205 TAYLOR BLVD, LOUISVILLE, KY 40215
(502) 368-4331
(502) 368-2315
Mailing address
3205 TAYLOR BLVD, LOUISVILLE, KY 40215
(502) 368-4331
(502) 368-2315
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5863
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5863
DENTAL LICENSE
—
Enumeration date
03/20/2007
Last updated
07/08/2007
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