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Individual

DR. EDWARD E. LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2961 RIVERMEADE DR NW, ATLANTA, GA 30327-2039
(404) 313-1243
Mailing address
2961 RIVERMEADE DR NW, ATLANTA, GA 30327-2039
(404) 313-1243

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN007894
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000150323A
GA
01
000150323B
MEDICAID
GA
Enumeration date
03/30/2007
Last updated
01/20/2024
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