Individual
DR. TODD TRABOR PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
943 CESERY BLVD, BUILDING # A, JACKSONVILLE, FL 32211-5635
(904) 743-5604
(904) 744-1490
Mailing address
943 CESERY BLVD, BUILDING # A, JACKSONVILLE, FL 32211-5635
(904) 743-5604
(904) 744-1490
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2901017095
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN18217
FL
Other
Enumeration date
02/21/2006
Last updated
04/06/2015
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