Individual
DR. MICHAEL FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2776 RINGGOLD RD, FORT SILL DENTAC, FORT SILL, OK 73503-6300
(580) 442-3905
(580) 442-4002
Mailing address
2776 RINGGOLD RD., USA DENTAL ACTIVITY, FORT SILL, OK 73503
(580) 442-3905
(580) 442-4002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024267L
PA
Other
Enumeration date
09/16/2006
Last updated
03/02/2011
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