Individual
DR. CHARLES MITCHELL LUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8009 BARDSTOWN RD, LOUISVILLE, KY 40291-3439
(502) 231-6474
(502) 231-6461
Mailing address
8009 BARDSTOWN RD, LOUISVILLE, KY 40291-3439
(502) 231-6474
(502) 231-6461
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7852
KY
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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