Provider Demographics
NPI:1457433054
Name:LUGER, JOANNE (DDS)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:LUGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 S 12TH ST
Mailing Address - Street 2:STE 1 BRIDGING THE DENTAL GAP INC
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504
Mailing Address - Country:US
Mailing Address - Phone:701-221-0537
Mailing Address - Fax:701-221-0537
Practice Address - Street 1:1223 S 12TH ST
Practice Address - Street 2:STE 1 BRIDGING THE DENTAL GAP INC
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504
Practice Address - Country:US
Practice Address - Phone:701-221-0518
Practice Address - Fax:701-221-0537
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND18201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND41357Medicaid