Angelo Luckett DDS PC
Dentist in Krebs, OK. Organization (NPI-2).
NPI number1710072772
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1710072772
- Entity type
- Organization (NPI-2)
- Legal business name
- Angelo Luckett DDS PC
- Organization subpart
- No
- Enumeration date
- Oct 4, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 2853 | OK | Yes |
Practice location
245 Main Street245 Main Street
Krebs, OK 74554
Phone 918-423-2286 · Fax 918-423-3506
Mailing address
Po Box 8245 Main Street
Krebs, OK 74554
Phone 918-423-2286 · Fax 918-423-3506
Authorized official
Angelo Luckett
Pres
9184232286
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