| Kickingbird Dental | |
|
1333 E Danforth Rd Edmond OK 73034-3201 | |
| (405) 359-9696 | |
| (405) 359-0808 |
| Full Name | Kickingbird Dental |
|---|---|
| Speciality | Dentist |
| Location | 1333 E Danforth Rd, Edmond, Oklahoma |
| Authorized Official Name and Position | Ashley Dussault (OFFICE MANAGER) |
| Authorized Official Contact | 4053599696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kickingbird Dental 1333 E Danforth Rd Edmond OK 73034-3201 Ph: (405) 359-9696 | Kickingbird Dental 1333 E Danforth Rd Edmond OK 73034-3201 Ph: (405) 359-9696 |
| NPI Number | 1174935142 |
|---|---|
| Provider Enumeration Date | 05/27/2014 |
| Last Update Date | 05/27/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174935142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | OK4913 (Oklahoma) | Primary |
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