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Individual

SCOTT A. PUCKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1665 ALEX DR, WILMINGTON, OH 45177
(937) 382-8020
(937) 382-8020
Mailing address
1665 ALEX DR, WILMINGTON, OH 45177
(937) 382-8020
(937) 382-8020

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
30-021139
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
30-021139
OH

Other

Enumeration date
03/31/2006
Last updated
09/11/2025
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