Provider Demographics
NPI:1891189353
Name:CARUBIA, LUCAS ROBERT (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:ROBERT
Last Name:CARUBIA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 HODGEN RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-1605
Mailing Address - Country:US
Mailing Address - Phone:719-640-1962
Mailing Address - Fax:
Practice Address - Street 1:313 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1221
Practice Address - Country:US
Practice Address - Phone:570-346-7760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0414971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry