# CUSTOM DENTAL OF NEWCASTLE, PLLC

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

## Provider details

- **NPI number:** 1871872135
- **Authorized official:** RENE RODGERS (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (405) 282-6440

## Contact information

- **Practice address:** 3290 N TRI-CITY, NEWCASTLE, OK 73065
- **Practice address phone:** (405) 657-0038
- **Mailing address:** 3290 N TRI-CITY, NEWCASTLE, OK 73065
- **Mailing address phone:** (405) 657-0038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6098 | OR | Yes |

## Other

- **Enumeration date:** 08/04/2011
- **Last updated:** 08/04/2011