# MARK E. METTRY DDS, INC.

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

## Provider details

- **NPI number:** 1710098140
- **Authorized official:** MARK ELLIS METTRY D.D.S. (OWNER)
- **Authorized official phone:** (405) 224-7036

## Contact information

- **Practice address:** 839 W COUNTRY CLUB RD, CHICKASHA, OK 73018-7281
- **Practice address phone:** (405) 224-7036
- **Practice address fax:** (405) 224-2702
- **Mailing address:** 839 W COUNTRY CLUB RD, CHICKASHA, OK 73018-7281
- **Mailing address phone:** (405) 224-7036
- **Mailing address fax:** (405) 224-2702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3949 | OK | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 08/22/2020
