| Coffee Creek Pediatric Dentistry Pllc | |
|
2800 N Kelly Ave Ste 200 Edmond OK 73003-3004 | |
| (405) 562-2222 | |
| Not Available |
| Full Name | Coffee Creek Pediatric Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2800 N Kelly Ave Ste 200, Edmond, Oklahoma |
| Authorized Official Name and Position | Stephanie Ferguson (OWNER) |
| Authorized Official Contact | 4055622222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coffee Creek Pediatric Dentistry Pllc 2800 N Kelly Ave Ste 200 Edmond OK 73003-3004 Ph: (405) 562-2222 | Coffee Creek Pediatric Dentistry Pllc 2800 N Kelly Ave Ste 200 Edmond OK 73003-3004 Ph: (405) 562-2222 |
| NPI Number | 1689331753 |
|---|---|
| Provider Enumeration Date | 11/23/2021 |
| Last Update Date | 11/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689331753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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