Individual
BRANDON CURTIS LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6540 SOUTH AVE, BOARDMAN, OH 44512-3651
(330) 758-6165
(330) 758-5547
Mailing address
4202 CLEARWATER CT, MISSOURI CITY, TX 77459-1668
(832) 875-2886
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
059651
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
30.026080
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30803
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DS043618
PA
Other
Enumeration date
03/05/2014
Last updated
03/02/2025
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