Edmond Pediatric And Teen Dentistry | |
3824 S. Boulevard Suite 110 Edmond OK 73013 | |
(405) 513-8811 | |
Not Available |
Full Name | Edmond Pediatric And Teen Dentistry |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 3824 S. Boulevard, Edmond, Oklahoma |
Authorized Official Name and Position | Heath Austin Whitfield (OWNER, PRESIDENT, OFFICER) |
Authorized Official Contact | 4055138811 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Edmond Pediatric And Teen Dentistry 3824 S. Boulevard Suite 110 Edmond OK 73013 Ph: (405) 513-8811 | Edmond Pediatric And Teen Dentistry 3824 S. Boulevard Suite 110 Edmond OK 73013 Ph: (405) 513-8811 |
NPI Number | 1235419409 |
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Provider Enumeration Date | 08/19/2011 |
Last Update Date | 08/19/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235419409 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 6048 (Oklahoma) | Primary |
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