Custom Dental Of Yukon, Pllc | |
4425 Grant Blvd Yukon OK 73099 | |
(405) 494-4856 | |
(405) 494-4184 |
Full Name | Custom Dental Of Yukon, Pllc |
---|---|
Speciality | Clinic/center - Dental |
Location | 4425 Grant Blvd, Yukon, Oklahoma |
Authorized Official Name and Position | Katelyn Johnson (OWNER-DOCTOR) |
Authorized Official Contact | 9188399088 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Custom Dental Of Yukon, Pllc 4425 Grant Blvd Yukon OK 73099 Ph: (405) 494-4856 | Custom Dental Of Yukon, Pllc 4425 Grant Blvd Yukon OK 73099 Ph: (405) 494-4856 |
NPI Number | 1164049185 |
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Provider Enumeration Date | 06/26/2020 |
Last Update Date | 06/26/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164049185 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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› Verified 9 days ago
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