Individual
JONATHAN LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10056 PINES BLVD, PEMBROKE PINES, FL 33024-6137
(954) 432-7223
Mailing address
11141 SW 64TH AVE, PINECREST, FL 33156-4068
(305) 772-8393
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
25980
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN25980
FL
Other
Enumeration date
06/17/2024
Last updated
02/10/2026
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