Individual
DR. SHANNON MARIE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1638 W FRYE RD, PHOENIX, AZ 85045-1737
(602) 363-9338
Mailing address
1638 W FRYE RD, PHOENIX, AZ 85045-1737
(602) 363-9338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D008690
AZ
1223G0001X
General Practice Dentistry
DGD.8153 GD
SC
Other
Enumeration date
09/28/2012
Last updated
05/09/2026
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