Organization
BETTY TUCKER, D.D.S., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY HUANG TUCKER DDS (PRESIDENT)
(419) 463-0023
Entity
Organization
Contact information
Practice address
6438 WILMINGTON PIKE STE 205, CENTERVILLE, OH 45459-7023
(937) 848-1116
Mailing address
8607 SEA PINES LN, DAYTON, OH 45458-3321
(419) 463-0023
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30.023424
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054438
—
OH
Enumeration date
09/08/2017
Last updated
09/08/2017
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