Organization · Type 2 NPI
Michael A. Luckett D.m.d. & Associates (rivercrest), Ltd.
General Practice Dentistry · Crestwood, IL
NPI number
1174594378
Active
Practice location
4839 West Calsag Rd, #310
Crestwood, IL 60445-4415
Fax (216) 584-1062
Mailing address
PO Box 860036
Minneapolis, MN 55486
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | None listed |
| Endodontics | 1223E0200X | None listed |
| General Practice Dentistry Primary | 1223G0001X | 019.019835 (IL) |
| Pediatric Dentistry | 1223P0221X | None listed |
| Periodontics | 1223P0300X | None listed |
| Prosthodontics | 1223P0700X | None listed |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | None listed |
General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
About NPI 1174594378
Michael A. Luckett D.m.d. & Associates (rivercrest), Ltd.'s National Provider Identifier is 1174594378, issued on Jan 27, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Crestwood, IL. The record was last updated on Dec 8, 2016.