# ADVANCED CRANIOFACIAL PAIN CARE CLINIC PLLC

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

## Provider details

- **NPI number:** 1568782969
- **Authorized official:** TERESA K DAVIS DDS (PRESIDENT)
- **Authorized official phone:** (405) 751-5515

## Contact information

- **Practice address:** 4401 W MEMORIAL RD, SUITE 135, OKLAHOMA CITY, OK 73134-1785
- **Practice address phone:** (405) 751-5515
- **Practice address fax:** (405) 751-6606
- **Mailing address:** 4401 W MEMORIAL RD, SUITE 135, OKLAHOMA CITY, OK 73134-1785
- **Mailing address phone:** (405) 751-5515
- **Mailing address fax:** (405) 751-6606

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5510 | OK | Yes |

## Other

- **Enumeration date:** 06/08/2010
- **Last updated:** 06/08/2010