# CARRIE DS FAMILY DENTISTRY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Riverwalk Dental Spa
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750688248
- **Authorized official:** DR. CARRIE D SESSOM D.D.S. (OWNER)
- **Authorized official phone:** (918) 392-7654

## Contact information

- **Practice address:** 400 RIVERWALK TERRACE, SUITE 200, JENKS, OK 74037-5627
- **Practice address phone:** (918) 392-7654
- **Practice address fax:** (918) 518-5760
- **Mailing address:** 400 RIVERWALK TERRACE, SUITE 200, JENKS, OK 74037-5627
- **Mailing address phone:** (918) 392-7654
- **Mailing address fax:** (918) 518-5760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5239 | OK | Yes |
| 332BC3200X | Customized Equipment (DME) | — | — | — |

## Other

- **Enumeration date:** 02/17/2011
- **Last updated:** 09/09/2014