| Ronisha Durham Dds Pllc | |
|
15260 Lleytons Ct Edmond OK 73013-7301 | |
| (405) 492-7862 | |
| Not Available |
| Full Name | Ronisha Durham Dds Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 15260 Lleytons Ct, Edmond, Oklahoma |
| Authorized Official Name and Position | Ronisha Durham (OWNER/DENTIST) |
| Authorized Official Contact | 4055692604 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronisha Durham Dds Pllc 2701 N 23rd St Apt 2403 Broken Arrow OK 74014-2171 Ph: (405) 569-2604 | Ronisha Durham Dds Pllc 15260 Lleytons Ct Edmond OK 73013-7301 Ph: (405) 492-7862 |
| NPI Number | 1396458857 |
|---|---|
| Provider Enumeration Date | 12/29/2022 |
| Last Update Date | 12/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396458857 | NPI | - | NPPES |
| 200432880A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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