| Kingfisher Dental Pllc | |
|
2302 Frontage Rd Kingfisher OK 73750-4810 | |
| (405) 375-5855 | |
| (405) 375-5863 |
| Full Name | Kingfisher Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2302 Frontage Rd, Kingfisher, Oklahoma |
| Authorized Official Name and Position | Benjamin James Bowman (OWNER) |
| Authorized Official Contact | 4053755855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingfisher Dental Pllc 2302 Frontage Rd Kingfisher OK 73750-4810 Ph: (405) 375-5855 | Kingfisher Dental Pllc 2302 Frontage Rd Kingfisher OK 73750-4810 Ph: (405) 375-5855 |
| NPI Number | 1982967618 |
|---|---|
| Provider Enumeration Date | 06/18/2012 |
| Last Update Date | 06/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982967618 | NPI | - | NPPES |
| 200208490A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6076 (Oklahoma) | Primary |
Kingfisher Dental Designs Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 Hospital Cir, Kingfisher, OK 73750 Phone: 405-375-3857 | |
Kingfisher Dentistry And Braces Dental Clinic Medicare: Medicare Enrolled Practice Location: 100 Starlite Dr, Kingfisher, OK 73750 Phone: 405-375-5855 Fax: 405-358-2946 |