| Mydentist-ardmore | |
|
2401 12th Ave Nw Ste 103 Ardmore OK 73401-1471 | |
| (580) 233-5962 | |
| (580) 223-5956 |
| Full Name | Mydentist-ardmore |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2401 12th Ave Nw Ste 103, Ardmore, Oklahoma |
| Authorized Official Name and Position | Hannah Fish (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175405699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mydentist-ardmore 2401 12th Ave Nw Ste 103 Ardmore OK 73401-1471 Ph: () - | Mydentist-ardmore 2401 12th Ave Nw Ste 103 Ardmore OK 73401-1471 Ph: (580) 233-5962 |
| NPI Number | 1750701603 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750701603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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