Provider Demographics
NPI:1124221692
Name:LUGUS, KARL EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:EDWARD
Last Name:LUGUS
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:749 OLD NORCROSS RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045
Mailing Address - Country:US
Mailing Address - Phone:770-995-3220
Mailing Address - Fax:770-995-5226
Practice Address - Street 1:749 OLD NORCROSS RD
Practice Address - Street 2:SUITE B
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045
Practice Address - Country:US
Practice Address - Phone:770-995-3220
Practice Address - Fax:770-995-5226
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA100451223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry