Provider Demographics
NPI:1841201209
Name:LUCAS, ALAN D (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:LUCAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6657 U S HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8442
Mailing Address - Country:US
Mailing Address - Phone:601-264-0537
Mailing Address - Fax:601-268-7395
Practice Address - Street 1:6657 U S HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-8442
Practice Address - Country:US
Practice Address - Phone:601-264-0537
Practice Address - Fax:601-268-7395
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2496-891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice