Organization
JASON LUCHTEFELD, DMD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LUCHTEFELD (MEMBER)
(618) 544-2626
Entity
Organization
Contact information
Practice address
1502 W MAIN ST, ROBINSON, IL 62454-3819
(618) 544-2626
Mailing address
1502 W MAIN ST, ROBINSON, IL 62454-3819
(618) 544-2626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027847
IL
Other
Enumeration date
11/17/2011
Last updated
11/17/2011
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