# L.G. PUCKETT D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477859130
- **Authorized official:** DR. LUTHER G PUCKETT IV DDS (DENTIST)
- **Authorized official phone:** (931) 823-3754

## Contact information

- **Practice address:** 508 N CHURCH ST, LIVINGSTON, TN 38570-1539
- **Practice address phone:** (931) 823-3754
- **Practice address fax:** (931) 823-3739
- **Mailing address:** 508 N CHURCH ST, LIVINGSTON, TN 38570-1539
- **Mailing address phone:** (931) 823-3754
- **Mailing address fax:** (931) 823-3739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8548 | TN | Yes |

## Other

- **Enumeration date:** 01/28/2011
- **Last updated:** 01/28/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5440979 | — | TN |