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General NPI Number Information
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NPI Number | 1679954788
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Entity Type | Individual
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Provider Name | CHRISTINA PUIG DMD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 98 C MICHAEL DAVENPORT BLVD
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City | FRANKFORT
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State | KY
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Zip | 40601-4333
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Country | US
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Telephone | 502-223-7186
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Fax | 502-996-8338
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Provider Business Mailing Address
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Address Line | 98 C MICHAEL DAVENPORT BLVD
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City | FRANKFORT
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State | KY
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Zip | 40601-4333
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Country | US
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Telephone | 502-223-7186
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Fax | 502-996-8338
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22180
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN22180
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 10850
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License Number State | KY
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