Provider Demographics
NPI:1346680717
Name:LUCY, DANA MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MARIE
Last Name:LUCY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 CORTEZ RD W
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3110
Mailing Address - Country:US
Mailing Address - Phone:941-756-4999
Mailing Address - Fax:941-756-0707
Practice Address - Street 1:4016 CORTEZ RD W
Practice Address - Street 2:SUITE 1101
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3110
Practice Address - Country:US
Practice Address - Phone:941-756-4999
Practice Address - Fax:941-756-0707
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20212122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist