# EL RENO DENTAL

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

## Provider details

- **NPI number:** 1922361104
- **Authorized official:** BENJAMIN BOWMAN D.D.S. (DENTIST)
- **Authorized official phone:** (405) 262-1919

## Contact information

- **Practice address:** 2005 PARKVIEW DR, SUITE 2, EL RENO, OK 73036-2150
- **Practice address phone:** (405) 262-1919
- **Mailing address:** 2005 PARKVIEW DR, SUITE 2, EL RENO, OK 73036-2150
- **Mailing address phone:** (405) 262-1919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6395 | OK | Yes |

## Other

- **Enumeration date:** 06/21/2012
- **Last updated:** 06/21/2012