Organization
KAREN BRYANT LUCKETT,DMD,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN BRYANT LUCKETT D.M.D. (OWNER/MEMBER)
(601) 684-3966
Entity
Organization
Contact information
Practice address
1121B DELAWARE AVE, MCCOMB, MS 39648-3829
(601) 684-3966
(601) 684-3875
Mailing address
1121B DELAWARE AVE, MCCOMB, MS 39648-3829
(601) 684-3966
(601) 684-3875
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2664-92
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660074
—
MS
Enumeration date
07/15/2014
Last updated
08/12/2016
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