Grand Avenue Dental Studio
NPI #1356047922 in Chickasha, Oklahoma
Provider Information
- NPI Number
- 1356047922
- Entity Type
- Organization
- Organization Name
- Grand Avenue Dental Studio
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Feb 6, 2023
- Last Updated
- Feb 6, 2023
Practice Location
Authorized Official
- Name
- TARA HANSELMAN
- Title
- OFFICE MANAGER
- Phone
- (405) 224-1311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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