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NPI #1669097804 in Enid, Oklahoma

Provider Information

NPI Number
1669097804
Entity Type
Individual
Name
Ace Logo
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dentist - General Practice
Enumeration Date
Jun 13, 2020
Last Updated
Jun 13, 2020

Practice Location

Address
402 S OAKWOOD RD STE D
City
Enid
ZIP Code
73703-4945
Phone
(580) 242-5862

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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