Individual
DR. EVAN DALE CLOTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
300 N ASPEN AVE, BROKEN ARROW, OK 74012-2205
(918) 251-3333
Mailing address
16534 E 49TH PL, TULSA, OK 74134-7190
(918) 251-8999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5817
OK
1223G0001X
General Practice Dentistry
7162
KS
Other
Enumeration date
05/15/2006
Last updated
07/08/2007
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