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Organization
LUSHDENTAL
Active
Organization
LUSHDENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHEDRACK OKOJIE DDS (OWNER)
(646) 256-2551
Entity
Organization
Contact information
Practice address
1912 SHERWOOD WAY, SAN ANGELO, TX 76901-3926
(646) 256-2551
Mailing address
1912 SHERWOOD WAY, SAN ANGELO, TX 76901-3926
(646) 256-2551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
32169
TX
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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