Individual
BRENDA J TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDA
Contact information
Practice address
7058 CORPORATE WAY, SUITE 3, CENTERVILLE, OH 45459-4295
(937) 586-7729
Mailing address
7058 CORPORATE WAY, SUITE 3, CENTERVILLE, OH 45459-4295
(937) 586-7729
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
51006003
OH
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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