| Randy Fagan Dds, Pc | |
|
2221 W Washington St Broken Arrow OK 74012-6726 | |
| (918) 455-6406 | |
| (918) 455-1856 |
| Full Name | Randy Fagan Dds, Pc |
|---|---|
| Speciality | Dentist |
| Location | 2221 W Washington St, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Randy James Fagan (PRESIDENT) |
| Authorized Official Contact | 9184556406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randy Fagan Dds, Pc 2221 W Washington St Broken Arrow OK 74012-6726 Ph: (918) 455-6406 | Randy Fagan Dds, Pc 2221 W Washington St Broken Arrow OK 74012-6726 Ph: (918) 455-6406 |
| NPI Number | 1083888036 |
|---|---|
| Provider Enumeration Date | 04/21/2008 |
| Last Update Date | 04/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083888036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5318 (Oklahoma) | Primary |
News Archive
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› Verified 1 days ago
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