Provider Demographics
NPI:1871755819
Name:MARRS, LUCAS BENJAMIN (DDS)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:BENJAMIN
Last Name:MARRS
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 1:6535 E 82ND ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-4524
Mailing Address - Country:US
Mailing Address - Phone:317-849-3597
Mailing Address - Fax:
Practice Address - Street 1:6535 E 82ND ST
Practice Address - Street 2:SUITE 211
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4524
Practice Address - Country:US
Practice Address - Phone:317-849-3597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011157A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist