Provider Demographics
NPI:1467469395
Name:UNDERHILL, LUKE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:UNDERHILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 EAGLE DR
Mailing Address - Street 2:BOX 924
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2024
Mailing Address - Country:US
Mailing Address - Phone:361-438-3940
Mailing Address - Fax:
Practice Address - Street 1:4110 EAGLE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-2024
Practice Address - Country:US
Practice Address - Phone:361-855-3195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice