| Blue River Smiles Pllc | |
|
1202 E Main St Tishomingo OK 73460-2409 | |
| (580) 371-2396 | |
| Not Available |
| Full Name | Blue River Smiles Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1202 E Main St, Tishomingo, Oklahoma |
| Authorized Official Name and Position | Joshua Brasher (PRESIDENT) |
| Authorized Official Contact | 4054746362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue River Smiles Pllc 3901 E Covell Rd Edmond OK 73034-6909 Ph: (405) 359-0808 | Blue River Smiles Pllc 1202 E Main St Tishomingo OK 73460-2409 Ph: (580) 371-2396 |
| NPI Number | 1760069520 |
|---|---|
| Provider Enumeration Date | 03/26/2021 |
| Last Update Date | 03/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760069520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Ron Austin, Dds, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 E Main St, Tishomingo, OK 73460 Phone: 580-371-2396 Fax: 580-371-9785 | |
Parks Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 East Main Street, Tishomingo, OK 73460 Phone: 580-371-3900 Fax: 580-371-3903 |