Individual
DR. BRIAN GREGORY LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6900 ALDEN DR, FE WARREN AFB, WY 82005-2945
(307) 773-5623
Mailing address
18 FORT WARREN AVE UNIT A, CHEYENNE, WY 82001-8265
(304) 923-7930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4517
WV
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/05/2021
Last updated
08/24/2022
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