Custom Dental of Edmond, Pllc
NPI #1013211846 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1013211846
- Entity Type
- Organization
- Organization Name
- Custom Dental of Edmond, Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jan 10, 2011
- Last Updated
- Sep 15, 2011
Practice Location
- Address
- 17840 N. PENN
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73012
- Phone
- (405) 282-6440
Authorized Official
- Name
- DR. GRANT PITT, DDS
- Title
- DENTIST
- Phone
- (405) 282-6440
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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