Provider Demographics
NPI:1841367505
Name:LUCAS, JONATHAN DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:LUCAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:360 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7215
Mailing Address - Country:US
Mailing Address - Phone:615-771-3535
Mailing Address - Fax:615-771-1998
Practice Address - Street 1:360 COOL SPRINGS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-7215
Practice Address - Country:US
Practice Address - Phone:615-771-3535
Practice Address - Fax:615-771-1998
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNDS73611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics