Provider Demographics
NPI:1831129428
Name:LUKAS, RADD WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:RADD
Middle Name:WILLIAM
Last Name:LUKAS
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 1:8300 N THORNYDALE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-1168
Mailing Address - Country:US
Mailing Address - Phone:520-744-5150
Mailing Address - Fax:520-744-5322
Practice Address - Street 1:8300 N THORNYDALE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-1167
Practice Address - Country:US
Practice Address - Phone:520-744-5150
Practice Address - Fax:520-744-5322
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice