Provider Demographics
NPI:1932320223
Name:LUA, MARIE JOYCELYN (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:JOYCELYN
Last Name:LUA
Suffix:
Gender:F
Credentials:DMD MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6545 FRANCE AVE S
Mailing Address - Street 2:SUITE 680
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435
Mailing Address - Country:US
Mailing Address - Phone:952-922-5326
Mailing Address - Fax:952-922-5367
Practice Address - Street 1:6545 FRANCE AVE S
Practice Address - Street 2:SUITE 680
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435
Practice Address - Country:US
Practice Address - Phone:952-922-5326
Practice Address - Fax:952-922-5367
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MND109271223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics