# MUSTANG NORTH DENTAL

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

## Provider details

- **NPI number:** 1386246205
- **Authorized official:** BENJAMIN BOWMAN (OWNER)
- **Authorized official phone:** (405) 326-8004

## Contact information

- **Practice address:** 1709 S MUSTANG RD, STE A, YUKON, OK 73099
- **Practice address phone:** (405) 862-7007
- **Mailing address:** 1709 S MUSTANG RD, STE A, YUKON, OK 73099
- **Mailing address phone:** (405) 862-7007

## Taxonomy

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

## Other

- **Enumeration date:** 11/16/2020
- **Last updated:** 05/17/2021