# EAGLE CREEK FAMILY DENTISTRY PLLC

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

## Provider details

- **NPI number:** 1306331194
- **Authorized official:** TONI WHITE (INSURANCE COORDINATOR)
- **Authorized official phone:** (405) 844-6333

## Contact information

- **Practice address:** 4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120-8386
- **Practice address phone:** (405) 622-5612
- **Mailing address:** 775 W COVELL RD STE 160, EDMOND, OK 73003-2302
- **Mailing address phone:** (405) 844-6333

## Taxonomy

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

## Other

- **Enumeration date:** 06/25/2018
- **Last updated:** 06/25/2018