Individual
JANSEN RICHINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17420 MERCURY LN, EDMOND, OK 73012-7069
(705) 216-3752
Mailing address
17420 MERCURY LN, EDMOND, OK 73012-7069
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6014
OK
Other
Enumeration date
09/27/2008
Last updated
09/27/2008
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