Impressions Dental

NPI #1144494147 in Shawnee, Oklahoma

Provider Information

NPI Number: 1144494147
Entity Type: Organization
Organization Name: Impressions Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 22, 2008
Last Updated: Apr 22, 2008

Practice Location

Address: 2510 E INDEPENDENCE ST STE 600
City: Shawnee
State: Oklahoma
ZIP Code: 74804-1839
Phone: (405) 273-2002

Authorized Official

Name: DR. RENALLA KAYE ELLIS, D.D.S.
Title: OWNER
Phone: (405) 273-2002

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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