Provider Demographics
NPI:1700859030
Name:CHRISTIAN J LUZAR DMD INC
Entity Type:Organization
Organization Name:CHRISTIAN J LUZAR DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUZAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:760-674-8881
Mailing Address - Street 1:41-750 RANCHO LAS PALMAS
Mailing Address - Street 2:E 1
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-674-8881
Mailing Address - Fax:760-674-8882
Practice Address - Street 1:41-750 RANCHO LAS PALMAS
Practice Address - Street 2:E 1
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-674-8881
Practice Address - Fax:760-674-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46106122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty