Organization
MIDDLETOWN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PUCCIO DDS (OWNER)
(513) 423-0779
Entity
Organization
Contact information
Practice address
2402 CENTRAL AVE., MIDDLETOWN, OH 45042-4692
(513) 423-0779
(513) 423-7731
Mailing address
2402 CENTRAL AVE., MIDDLETOWN, OH 45042-4692
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-019191
OH
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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