Provider Demographics
NPI:1437239407
Name:LUTES, KARL IRVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:IRVIN
Last Name:LUTES
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 1:422 FOXHUNT DR
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-7443
Mailing Address - Country:US
Mailing Address - Phone:859-485-3001
Mailing Address - Fax:
Practice Address - Street 1:225 THOMAS MORE PKWY
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3423
Practice Address - Country:US
Practice Address - Phone:859-426-9700
Practice Address - Fax:859-426-8442
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY61131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice