National Provider Identifier

Judith Ellen Lucas, CDA-RDA

Judith Ellen Lucas, CDA-RDA is listed in the NPPES registry with a primary specialty of Dental Assistant in Lackawanna, NY and a listed phone number of (716) 823-9352.

NPI 1629392634Lackawanna, NYDental Assistant

Profile Overview

NPI
1629392634
Provider Type
Individual
Primary Specialty
Dental Assistant
Enumeration Date
March 19, 2010
Last Updated
March 19, 2010

Practice Location

  • 790 Ridge RD
  • Lackawanna, NY 14218-1629

Phone: (716) 823-9352

Specialties

  • Dental Assistant (126800000X)
Full Record
NPI
1629392634
Entity Type
Individual
Last Name
Lucas
First Name
Judith
Middle Name
Ellen
Name Prefix
Mrs.
Credential
CDA-RDA
Mailing Street Address
790 Ridge RD
Mailing City
Lackawanna
Mailing State
NY
Mailing ZIP Code
14218-1629
Mailing Country
US
Mailing Phone
(716) 823-9352
Practice Street Address
790 Ridge RD
Practice City
Lackawanna
Practice State
NY
Practice ZIP Code
14218-1629
Practice Country
US
Practice Phone
(716) 823-9352
Enumeration Date
March 19, 2010
Last Updated
March 19, 2010
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Dental Assistant (126800000X)