Puckett, C Ray
Puckett, C Ray is an individual health care provider with primary practice located at 2150 Hwy 54 S , Alamogordo NM 88011. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Puckett, C Ray can be contacted via phone (575) 443-8133.Contact Information
Primary practice address
2150 Hwy 54 S
Alamogordo NM 88011
Phone: (575) 443-8133
Fax: (575) 267-1747
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DD1726 | New Mexico |
Profile Details
| NPI number | 1568456705 |
|---|---|
| LBN Legal business name | Puckett, C Ray |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 2nd, 2005 |
| Last updated | Jul 15th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568456705 | NPPES |
| New Mexico | MEDICAID | 84927 |
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