CUSTOM DENTAL OF OWASSO, PLLC
Organization (NPI-2)
Active
Dentist
Provider Information
- NPI Number
1659689248- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 11501 N. 135TH EAST AVE, OWASSO, OK, 74055
- Phone
- (918) 371-7645
- Fax
- (918) 371-7272
Specialties & Taxonomies
Dentist
Primary License: OK #6099