| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KELLI R LUCIA | 1811062664 | 2024-07-05 |
Kelli R Lucia is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1811062664. Registration indicates Kelli R Lucia is a provider of access to dental specialists services with a specialization in Dental Providers, Dentist (Dental Providers, Dentist) (Dentist: Pediatric Dentistry, ) (Dental, ) (Dentist Pediatric Dentistry, Dental Providers) (Dentist, )
| Entity Type | Individual |
| Provider Name | Kelli R Lucia D.D.S. |
| Practice Office Address | 6443 W 10TH ST STE 204 INDIANAPOLIS, IN US |
| Practice Office Telephone | 3177548486 |
| Mailing Address | 7805 TIMBER RUN LN STE 100 INDIANAPOLIS, IN 462564734 US |
| Business Telephone | 3172133403 |
| Code | Practice | License No State |
|---|---|---|
| 1223P0221X PRIMARY | Access to Dental Specialists Dental Providers Dentist Dental Providers Dentist Dentist: Pediatric Dentistry Dental Dentist Pediatric Dentistry Dental Providers Dentist | 12009481
IN |
| 100199300 | MEDICAID | IN |