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Organization

LUMINA DENTAL OF LUTZ, PA

Active
Other names
LUMINA DENTAL OF LUTZ
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN D IVEY DMD (OWNER)
(813) 381-5858
Entity
Organization

Contact information

Practice address
2425 BRUNELLO TRCE, LUTZ, FL 33558-7800
(813) 381-5858
Mailing address
2945 GUINEVERE DR, TITUSVILLE, FL 32780-5916
(321) 431-2208

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
12/18/2019
Last updated
12/18/2019
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