Provider Demographics
NPI:1467938555
Name:DAN M. LUTHER, DMD, PC
Entity Type:Organization
Organization Name:DAN M. LUTHER, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:L
Authorized Official - Last Name:LUTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-539-9635
Mailing Address - Street 1:2305 WHITESBURG DR SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3819
Mailing Address - Country:US
Mailing Address - Phone:256-539-9635
Mailing Address - Fax:256-539-9635
Practice Address - Street 1:2305 WHITESBURG DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3819
Practice Address - Country:US
Practice Address - Phone:256-539-9635
Practice Address - Fax:256-539-9635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4387261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental