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Individual

DR. GREGORY S PUCKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
517 HIGHLAND AVE., VINE GROVE, KY 40175-1461
(270) 877-5553
Mailing address
517 HIGHLAND AVE, VINE GROVE, KY 40175-1461
(270) 877-5553

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6383
KY

Other

Enumeration date
11/12/2007
Last updated
01/14/2010
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