Grand Ave Dental Center Pllc

NPI #1336450675 in Chickasha, Oklahoma

Provider Information

NPI Number: 1336450675
Entity Type: Organization
Organization Name: Grand Ave Dental Center Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 1, 2010
Last Updated: Jul 1, 2010

Practice Location

Address: 720 W GRAND AVE
City: Chickasha
State: Oklahoma
ZIP Code: 73018-5743
Phone: (405) 224-1311

Authorized Official

Name: DR. GEORGE W. WILLIAMS III, DDS
Title: MEMBER
Phone: (405) 224-1311

Specialties & Taxonomy Codes

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

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