Provider Demographics
NPI:1649532896
Name:LUTZ, STEVEN DAVIS II (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DAVIS
Last Name:LUTZ
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:24651-1005
Mailing Address - Country:US
Mailing Address - Phone:276-988-4549
Mailing Address - Fax:276-988-4186
Practice Address - Street 1:215 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651-1005
Practice Address - Country:US
Practice Address - Phone:276-988-4549
Practice Address - Fax:276-988-4186
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist