Puckett Family Dentistry

NPI #1447410089 in Brandon, Mississippi

Provider Information

NPI Number: 1447410089
Entity Type: Organization
Organization Name: Puckett Family Dentistry
Primary Specialty: Dentist
Enumeration Date: Jun 16, 2008
Last Updated: Jun 16, 2008

Practice Location

Address: 6181 HIGHWAY 18
City: Brandon
State: Mississippi
ZIP Code: 39042-0000
Phone: (601) 825-0559

Authorized Official

Name: DR. STEPHANIE TULLOS, DMD
Title: DENTIST/OWNER
Phone: (601) 825-0559

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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