Individual
MACKENZIE LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2560 BYPASS RD, WINCHESTER, KY 40391-2387
(859) 737-1000
Mailing address
105 SPRUCE ST, LEXINGTON, KY 40507-2109
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9964
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
10/11/2019
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