Provider Demographics
NPI:1114067154
Name:NAZARIO CORREA, LUCAS J (DMD)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:J
Last Name:NAZARIO CORREA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 ROLLING MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-9542
Mailing Address - Country:US
Mailing Address - Phone:919-400-7143
Mailing Address - Fax:
Practice Address - Street 1:1001 WIDEWATERS PKWY
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-6102
Practice Address - Country:US
Practice Address - Phone:919-266-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice