Organization
DRAPER DENTAL PC
Active
Other names
Robert M Lucero
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT M LUCERO DDS (OWNER PRESIDENT)
(801) 553-9824
Entity
Organization
Contact information
Practice address
668 E 12225 S, SUITE 101, DRAPER, UT 84020-8340
(801) 553-9824
(801) 553-0471
Mailing address
668 E 12225 S, SUITE 101, DRAPER, UT 84020-8340
(801) 553-9824
(801) 553-0471
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
279701-9922
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
783866
UNITED CONCORDIA
—
Enumeration date
08/09/2006
Last updated
04/20/2017
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