| Pediatric Dental Associates Pc | |
|
1103 Walnut Drive Pediatric Dental Associates Pc Ardmore OK 73401 | |
| (580) 226-6290 | |
| (580) 223-4381 |
| Full Name | Pediatric Dental Associates Pc |
|---|---|
| Speciality | Dentist |
| Location | 1103 Walnut Drive, Ardmore, Oklahoma |
| Authorized Official Name and Position | Eugene A Litteken (PRESIDENT) |
| Authorized Official Contact | 5802266290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Dental Associates Pc 1103 Walnut Drive Pediatric Dental Associates Pc Ardmore OK 73401 Ph: (580) 226-6290 | Pediatric Dental Associates Pc 1103 Walnut Drive Pediatric Dental Associates Pc Ardmore OK 73401 Ph: (580) 226-6290 |
| NPI Number | 1447328349 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 06/28/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447328349 | NPI | - | NPPES |
| 100182220C | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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