Shadybrook Cosmetic & Family Dentistry | |
2809 Shadybrook Dr Midwest City OK 73110-3121 | |
(405) 737-3441 | |
Not Available |
Full Name | Shadybrook Cosmetic & Family Dentistry |
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Speciality | Dentist |
Location | 2809 Shadybrook Dr, Midwest City, Oklahoma |
Authorized Official Name and Position | Tanya L Rodgers (OFFICE MANAGER) |
Authorized Official Contact | 4057373441 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Shadybrook Cosmetic & Family Dentistry 2809 Shadybrook Dr Midwest City OK 73110-3121 Ph: (405) 737-3441 | Shadybrook Cosmetic & Family Dentistry 2809 Shadybrook Dr Midwest City OK 73110-3121 Ph: (405) 737-3441 |
NPI Number | 1609042910 |
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Provider Enumeration Date | 05/06/2008 |
Last Update Date | 05/06/2008 |
Identifier | Type | State | Issuer |
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1609042910 | NPI | - | NPPES |
1831134295 | Other | OK | TYPE I NPI |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 5183 (Oklahoma) | Primary |
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