Provider Demographics
NPI:1306165626
Name:JUTRAS, LUZ MARINA D (DMD)
Entity type:Individual
Prefix:DR
First Name:LUZ MARINA
Middle Name:D
Last Name:JUTRAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 ARGILLA RD
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-1704
Mailing Address - Country:US
Mailing Address - Phone:978-973-7440
Mailing Address - Fax:978-349-6118
Practice Address - Street 1:22 MILL ST STE 104
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476
Practice Address - Country:US
Practice Address - Phone:781-648-0279
Practice Address - Fax:781-641-3143
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18553861223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics