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Individual

JADE ROSE PUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
600 B ST, LIVINGSTON, CA 95334-9593
(833) 850-3500
Mailing address
600 B ST, LIVINGSTON, CA 95334-9593
(833) 850-3500

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
30776
CA

Other

Enumeration date
11/26/2019
Last updated
11/26/2019
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