Provider Demographics
NPI:1497961601
Name:LUKAS, LAURITA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURITA
Middle Name:M
Last Name:LUKAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W BUTTERFIELD RD
Mailing Address - Street 2:#314
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5060
Mailing Address - Country:US
Mailing Address - Phone:630-834-2257
Mailing Address - Fax:
Practice Address - Street 1:10775 N ROUTE 47
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142
Practice Address - Country:US
Practice Address - Phone:847-669-4771
Practice Address - Fax:847-669-4772
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice