Individual
WESLEY R. LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1120 18TH ST, WOODWARD, OK 73801-2921
(580) 256-6054
Mailing address
1120 18TH ST, WOODWARD, OK 73801-2921
(580) 256-6054
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3239
OK
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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