MATTIE ELIZABETH EDDLEMAN
Individual Provider (NPI-1)
Active
Dentist, General Practice
Provider Information
- NPI Number
1083346241- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 780 SW 19TH ST, MOORE, OK, 731603054
- Phone
- (402) 669-2590
Specialties & Taxonomies
Dentist, General Practice
Primary License: OK #7639
All Addresses
MAILING
780 SW 19TH ST
MOORE, OK, 731603054