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NPI 1669097804

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NPI 1669097804 · General Practice Dentistry · Enid, OK

Provider details

NPI number: 1669097804
Entity type: Individual
Primary specialty: General Practice DentistryDental Providers
Sex: Male
Sole proprietor: No
License: 7292 (OK)

Practice location

402 S Oakwood Rd Ste D

Enid, OK 73703-4945

Phone: (580) 242-5862

More OK providers

Mailing address

402 S Oakwood Rd Ste D

Enid, OK 73703-4945

Registry dates

Enumerated: 2020-06-13
Last updated: 2020-06-13

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

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