# COWETA DENTAL AND IMPLANTS

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

## Provider details

- **NPI number:** 1154015790
- **Authorized official:** BRAD NELSON (OWNER)
- **Authorized official phone:** (405) 260-6080

## Contact information

- **Practice address:** 129 S BROADWAY, COWETA, OK 74429-4101
- **Practice address phone:** (918) 279-8880
- **Mailing address:** 5700 SE 89TH ST, OKLAHOMA CITY, OK 73135-6017

## Taxonomy

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

## Other

- **Enumeration date:** 06/06/2023
- **Last updated:** 02/05/2024