Individual
DR. AUTUMN RENAE SACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
126 HILL STREET, BUCYRUS, OH 44820
(419) 562-0203
(419) 562-4467
Mailing address
126 HILL STREET, BUCYRUS, OH 44820
(419) 562-0203
(419) 562-4467
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21265
OH
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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