Individual
CHASE C YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2025 S GORDON COOPER DR, SHAWNEE, OK 74801-9005
(405) 307-9704
Mailing address
2025 S GORDON COOPER DR, SHAWNEE, OK 74801-9005
(405) 307-9704
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6052
OK
Other
Enumeration date
07/08/2008
Last updated
09/13/2011
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