DR. Randy J Fagan, DDS
NPI #1487628731 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1487628731
- Entity Type
- Individual
- Name
- DR. Randy J Fagan, DDS
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Dentist
- Credential
- DDS
- Enumeration Date
- Feb 14, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 2221 W WASHINGTON ST
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-6726
- Phone
- (918) 455-6406
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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