Shankle Dental-Broken Arrow Pllc
NPI #1265902183 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1265902183
- Entity Type
- Organization
- Organization Name
- Shankle Dental-Broken Arrow Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Dec 4, 2018
- Last Updated
- Jun 20, 2024
Practice Location
- Address
- 2522 E KENOSHA ST.
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74014-6712
- Phone
- (918) 355-1391
Authorized Official
- Name
- RON FERNANDEZ
- Title
- CEO
- Phone
- (918) 960-3070
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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