Individual
VASHTI OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 LONNIE ABBOTT BLVD, ADA, OK 74820-1851
(580) 279-1716
(580) 279-1591
Mailing address
1430 LONNIE ABBOTT BLVD, ADA, OK 74820-1851
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6953
OK
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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