Most Relevant Information
Provider Data
| NPI Number: | 1003224833 |
| Provider Name: | STEPHANIE N LUCKETT DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 9477 |
Most Important Dates
| Enumeration Date: | 07/24/2014 |
| Last Updated: | 08/06/2016 |
Provider Practice Location
2215 PORTLAND AVE
LOUISVILLE
KY
402121033
Practice Location Phone/Fax
| Phone: | 5027728160 |
| Fax: | 5027728108 |
Provider Mailing Location
2215 PORTLAND AVENUE
LOUISVILLE
KY
402423214
Provider Mailing Phone/Fax
| Phone: | 5027728160 |
| Fax: | 5027728108 |