Provider Demographics
NPI:1285822239
Name:LUCAS, HEATHER RILEY (DMD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:RILEY
Last Name:LUCAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8780 US HIGHWAY 42 STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-8850
Mailing Address - Country:US
Mailing Address - Phone:859-384-2999
Mailing Address - Fax:859-384-9888
Practice Address - Street 1:8780 US HIGHWAY 42 STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-8850
Practice Address - Country:US
Practice Address - Phone:859-384-2999
Practice Address - Fax:859-384-9888
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY72761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice