NPI 1306969910 · live from the CMS NPI Registry
Lucas Charles Deeter, DDS
Dentist, General Practice in Bismarck, ND. National Provider Identifier 1306969910, active.
NPI record
| NPI | 1306969910 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, General Practice 1223G0001X |
| Practice location | 1003 Gateway Ave, Bismarck, ND 58503 |
| Practice phone | 701-222-1800 |
| Mailing address | 623 Raymond St, Bismarck, ND 58501 |
| Enumerated | April 9, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, General Practice primary | 1223G0001X | 1223G0001X (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.