Provider Demographics
NPI:1205901766
Name:PERRIGO, LUCAS B (DMD)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:B
Last Name:PERRIGO
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 1:2038 PATTON CHAPEL ROAD
Mailing Address - Street 2:LUCAS B PERRIGO DMD PC
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216
Mailing Address - Country:US
Mailing Address - Phone:205-822-7822
Mailing Address - Fax:205-822-9452
Practice Address - Street 1:2038 PATTON CHAPEL ROAD
Practice Address - Street 2:LUCAS B PERRIGO DMD PC
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216
Practice Address - Country:US
Practice Address - Phone:205-822-7822
Practice Address - Fax:205-822-9452
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5188122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist