| NPI | 1548697337 |
|---|---|
| Former Legal Business Name | BILLY PUCKETT |
| Entity Type | Organization |
| Authorized Contact | BILLY DWAIN PUCKETT Owner 832-649-7344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 24677) |
| Enumeration Date | 2013-10-11 |
| Last Update Date | 2013-10-11 |