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Organization

ALLEN AND HANSEN DENTISTRY PARTNERSHIP

Active
Other names
Shepherd Mall Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK JAY ALLEN DDS (PARTNEER)
(405) 844-6100
Entity
Organization

Contact information

Practice address
2401 NW 23RD ST, OKLAHOMA CITY, OK 73107-2442
(405) 942-0337
Mailing address
519 S SANTA FE AVE, EDMOND, OK 73003-6281
(405) 844-6100

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4333
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4333
DENTAL LICENSE
OK
Enumeration date
02/06/2018
Last updated
06/16/2018
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