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Organization
MUSTANG DENTISTRY & BRACES
Active
Organization
MUSTANG DENTISTRY & BRACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN JAMES BOWMAN DDS (MANAGER)
(405) 326-8004
Entity
Organization
Contact information
Practice address
1001 E. HIGHWAY 152, SUITE 113, MUSTANG, OK 73064
(405) 353-1388
Mailing address
1001 E HIGHWAY 152, SUITE 113, MUSTANG, OK 73064
(405) 353-1388
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6076
OK
Other
Enumeration date
07/10/2017
Last updated
10/29/2020
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