Individual
DR. RICHARD ALLEN LOLKUS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 421-1045
Mailing address
8310 SUMMERSET PL, FORT WAYNE, IN 46825-6439
(260) 489-7060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5481
CO
Other
Enumeration date
11/07/2005
Last updated
07/08/2007
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