Individual
DR. JOHN H. PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
624 W. COURT ST., SUITE A, PARGOULD, AR 72450-4247
(870) 236-5888
(870) 236-6888
Mailing address
PO BOX 1209, PARAGOULD, AR 72451-1209
(865) 236-5888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3406
AR
1223G0001X
General Practice Dentistry
8147
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176096608
—
AR
05
—
3206528
—
TN
Enumeration date
12/19/2005
Last updated
06/03/2009
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