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Contact Information

GRAND LAKE FAMILY DENTISTRY TRAVIS D LUTZ DDS- ROCKFORD LTD
160 E. WALNUT ST.
ROCKFORD, OH45882
 Phone: 419-363-3537
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for GRAND LAKE FAMILY DENTISTRY TRAVIS D LUTZ DDS ROCKFORD LTD · (Female)

NPI # 1366044158
Status Active
Credentials
Entity Individual
Enumeration date 11/16/2020
Last updated 11/16/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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