Blue River Smiles Pllc
NPI #1760069520 in Tishomingo, Oklahoma
Provider Information
- NPI Number
- 1760069520
- Entity Type
- Organization
- Organization Name
- Blue River Smiles Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Mar 26, 2021
- Last Updated
- Mar 26, 2021
Practice Location
- Address
- 1202 E MAIN ST
- City
- Tishomingo
- State
- Oklahoma
- ZIP Code
- 73460-2409
- Phone
- (580) 371-2396
Authorized Official
- Name
- JOSHUA BRASHER, DDS
- Title
- PRESIDENT
- Phone
- (405) 474-6362
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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