Individual
DR. LUCAS VAN WIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2773 B 1/2 RD, GRAND JUNCTION, CO 81503-3036
(970) 257-1103
(970) 257-7522
Mailing address
50 KUESTER LK, GRAND ISLAND, NE 68801-8609
(308) 390-5067
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00205244
CO
1223G0001X
General Practice Dentistry
00205244
CO
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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