| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LUCAS CHEMALE KALIL FOGACA | 1134796444 | 2021-06-06 |
Lucas Chemale Kalil Fogaca is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1134796444. Registration indicates Lucas Chemale Kalil Fogaca is a provider of access to dentists-general services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist: General Practice, ) (Dental, ) (Dentist General Practice, Dental Providers) (Dentist, )
| Entity Type | Individual |
| Provider Name | Dr. Lucas Chemale Kalil Fogaca DDS |
| Practice Office Address | 1717 SHIPYARD BLVD STE 120 WILMINGTON, NC US |
| Practice Office Telephone | 9103131511 |
| Mailing Address | 1717 SHIPYARD BLVD STE 120 WILMINGTON, NC 284038019 US |
| Code | Practice | License No State |
|---|---|---|
| 1223G0001X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist: General Practice Dental Dentist General Practice Dental Providers Dentist | 12220
NC |