Provider Demographics
NPI:1639218233
Name:LUKENS, TERRANCE MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:MICHAEL
Last Name:LUKENS
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 1:3807 SAN DIMAS ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5730
Mailing Address - Country:US
Mailing Address - Phone:661-327-0835
Mailing Address - Fax:661-327-0702
Practice Address - Street 1:3807 SAN DIMAS ST
Practice Address - Street 2:SUITE B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5730
Practice Address - Country:US
Practice Address - Phone:661-327-0835
Practice Address - Fax:661-327-0702
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA242361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice