Individual
BETTY HUANG TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2200 OLYMPIC ST, SPRINGFIELD, OH 45503-2858
(937) 390-0493
Mailing address
2200 OLYMPIC ST, SPRINGFIELD, OH 45503-2858
(419) 463-0023
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9005
KY
1223P0221X
Pediatric Dentistry
Primary
30-023424
OH
1223P0221X
Pediatric Dentistry
9005
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0054438
—
OH
Enumeration date
12/01/2009
Last updated
09/30/2022
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