Share Our Smiles Pllc

NPI #1710216981 in Yukon, Oklahoma

Provider Information

NPI Number: 1710216981
Entity Type: Organization
Organization Name: Share Our Smiles Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 16, 2009
Last Updated: Dec 16, 2009

Practice Location

Address: 1025 E VANDAMENT AVE
Address 2: SUITE 300
City: Yukon
State: Oklahoma
ZIP Code: 73099-4910
Phone: (405) 354-1861

Authorized Official

Name: DR. KEITH DALE COULSON, D.D.S.
Title: DENTIST
Phone: (405) 354-1861

Specialties & Taxonomy Codes

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

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