Custom Dental of Owasso, Pllc

NPI #1659689248 in Owasso, Oklahoma

Provider Information

NPI Number: 1659689248
Entity Type: Organization
Organization Name: Custom Dental of Owasso, Pllc
Primary Specialty: Dentist
Enumeration Date: Sep 17, 2010
Last Updated: Sep 17, 2010

Practice Location

Address: 11501 N. 135TH EAST AVE
City: Owasso
State: Oklahoma
ZIP Code: 74055
Phone: (918) 371-7645

Authorized Official

Name: DR. RON CAMPBELL, DDS
Title: DENTIST
Phone: (918) 371-7645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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