Provider Demographics
NPI:1801853841
Name:LUKOWSKI, OLAF R (DDS)
Entity type:Individual
Prefix:DR
First Name:OLAF
Middle Name:R
Last Name:LUKOWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY HOSPITAL CREDENTIALS OFFICE
Mailing Address - Street 2:KARLSRUHERSTR 144 NACHRICTEN KASERNE BLDG. 3607
Mailing Address - City:HEIDELBERG
Mailing Address - State:BADEN WURTEMBOURG
Mailing Address - Zip Code:69126
Mailing Address - Country:DE
Mailing Address - Phone:49622-117-2728
Mailing Address - Fax:
Practice Address - Street 1:CMR 442
Practice Address - Street 2:HEIDELBERG DENTAL ACTIVITY CREDENTIALS OFFICE
Practice Address - City:APO AE
Practice Address - State:NY
Practice Address - Zip Code:09042
Practice Address - Country:US
Practice Address - Phone:622-117-2288
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice