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1003224833
STEPHANIE N LUCKETT
LOUISVILLE, KY
NPI
1003224833
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Former Name
STEPHANIE N MITCHELL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: KY 9477)
Enumeration Date
2014-07-24
Last Update Date
2016-08-06
Business Address
-- STEPHANIE N LUCKETT DMD
2215 PORTLAND AVE
LOUISVILLE, KY 40212-1033
Phone number: 502-772-8160
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Mailing Address
-- STEPHANIE N LUCKETT DMD
2215 PORTLAND AVENUE
LOUISVILLE, KY 40242-3214
Phone number: 502-772-8160
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