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Individual

DR. BRYAN SOLOMON FIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1618 N 5TH ST, STE. 2, PONCA CITY, OK 74601-2746
(580) 762-5624
Mailing address
1618 N 5TH ST, STE. 2, PONCA CITY, OK 74601-2746
(580) 762-5624

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5424
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5424
STATE LICENSE
OK
Enumeration date
06/12/2006
Last updated
01/25/2013
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