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Individual

ALLEN W. SUMMERLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
100 NW 9TH ST, CHECOTAH, OK 74426-3018
(918) 473-3700
Mailing address
2716 E 39TH PL, TULSA, OK 74105-8209
(918) 453-8335

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5624
OK

Other

Enumeration date
12/13/2006
Last updated
06/04/2013
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