Individual
DR. JENNIFER LINDSAY KUCKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
12113 W LINEBAUGH AVE, TAMPA, FL 33626-1732
(813) 530-2145
Mailing address
1209 E CUMBERLAND AVE UNIT 2203, TAMPA, FL 33602-4261
(607) 235-4430
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24516
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2017
Last updated
11/06/2019
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