NPI 1053952796

Laval Alonzo Lucas-Perry, RDH

Practitioner Dental Hygienist Detroit, MI

Practice location

Address: 4727 Saint Antoine St STE 408, Detroit, MI 48201-1461
Phone: (313) 833-7309
Mailing address: 4494 Warwick Circle Dr, Grand Blanc, MI 48439-8337

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 2902018904 (MI)

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Registry record

NPI: 1053952796
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Oct 2019
Record last updated: 3 Oct 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.