Provider Demographics
NPI:1174184915
Name:LUCE DENTAL INC.
Entity Type:Organization
Organization Name:LUCE DENTAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:LADD
Authorized Official - Last Name:LUCE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-329-3894
Mailing Address - Street 1:PO BOX 4331
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36547-4331
Mailing Address - Country:US
Mailing Address - Phone:601-329-3894
Mailing Address - Fax:
Practice Address - Street 1:2025 WEST 1ST ST
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542
Practice Address - Country:US
Practice Address - Phone:251-968-7170
Practice Address - Fax:251-968-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental