Provider Demographics
NPI:1558880740
Name:LUTHER, DANIEL J (DDS, PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:LUTHER
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 EISENHOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15904-3217
Mailing Address - Country:US
Mailing Address - Phone:814-269-3629
Mailing Address - Fax:
Practice Address - Street 1:1415 EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-3217
Practice Address - Country:US
Practice Address - Phone:814-269-3629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0424211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice