Provider Demographics
NPI:1225714850
Name:LUCAS, ALEXANDER JAYMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JAYMES
Last Name:LUCAS
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 1:23678 US HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3336
Mailing Address - Country:US
Mailing Address - Phone:251-928-8770
Mailing Address - Fax:
Practice Address - Street 1:900 MCMEANS AVE
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-3308
Practice Address - Country:US
Practice Address - Phone:251-580-3788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007177-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice