Wanda Puckett is a Dentist in Lake Charles, Louisiana. Wanda Puckett practices all healthcare services and medical treatments related to Dentist. The NPI Number for Wanda Puckett is 1285734640. The last update date is 2013-08-21.
Wanda Puckett's current location address is 2000 Opelousas Street, Lake Charles, Louisiana. You can contact this provider via phone number 3374399983 and fax number 3374393224. The mailing address for Wanda Puckett is 2000 Opelousas Street, Lake Charles, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wanda Puckett |
|---|---|
| Address | 2000 Opelousas Street, Lake Charles, Louisiana |
| Phone Number | 3374399983 |
| Fax Number | 3374393224 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1285734640 |
|---|---|
| Provider Enumeration Date | 2006-09-25 |
| Last Updated Date | 2013-08-21 |
Provider Mailing Address Detail
| Address | 2000 Opelousas Street |
|---|---|
| City | Lake Charles |
| State | Louisiana (LA) |
| Post Code | 70601 |
| Phone Number | 3374399983 |
| Fax Number | 3374393224 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 366751 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 749308 | NY | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Wanda Puckett by the Centers for Medicare & Medicaid Services (CMS)?
The Wanda Puckett has been assigned the NPI (National Provider Identifier) 1285734640. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Wanda Puckett's physical address?
The Wanda Puckett is physically located at 2000 Opelousas Street, in the city of Lake Charles, LA, with the postal code 70601.
What is the Wanda Puckett's area of specialization and corresponding taxonomy classification?
The Wanda Puckett's specialty field is Dentist, and it falls under the taxonomy code 122300000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1285734640 to Wanda Puckett?
The Wanda Puckett received its 1285734640 assignment from the Centers for Medicare & Medicaid Services on 2006-09-25.
When was the information pertaining to Wanda Puckett most recently updated or revised?
The details related to Wanda Puckett, including its address, specialty, and other relevant information, were last updated or revised on 2013-08-21.