# LONE GROVE DENTISTRY & BRACES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063051795
- **Authorized official:** BENJAMIN JAMES BOWMAN (OWNER)
- **Authorized official phone:** (405) 375-5855

## Contact information

- **Practice address:** 16931 US HIGHWAY 70, LONE GROVE, OK 73443-6523
- **Practice address phone:** (580) 657-3117
- **Mailing address:** 16931 US HIGHWAY 70, LONE GROVE, OK 73443-6523

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/28/2019
- **Last updated:** 08/25/2020