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Organization (NPI-2) Active

Dentist, General Practice

Provider Information

NPI Number
1417108432
Provider Type
Organization / Facility (NPI-2)
Status
Active

Contact & Location

Address
3902 S 113TH WEST AVE, SAND SPRINGS, OK, 740632724
Phone
(918) 245-5800
Fax
(918) 245-5803

Specialties & Taxonomies

Dentist, General Practice Primary License: OK #OK5700

All Addresses

MAILING

1201 E 42ND PL

SAND SPRINGS, OK, 740633849

(918) 346-1900

LOCATION

3902 S 113TH WEST AVE

SAND SPRINGS, OK, 740632724

(918) 245-5800