Individual
DAWN ANNETTE HISEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1140 BROOKSIDE CT, EDMOND, OK 73025-9748
(405) 850-0854
Mailing address
PO BOX 30342, EDMOND, OK 73003-0006
(405) 850-0854
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6160
OK
Other
Enumeration date
04/13/2011
Last updated
01/12/2012
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