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Individual

DR. TARA ANN STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
7130 W HEFNER RD, OKLAHOMA CITY, OK 73162-4502
(405) 595-0585
Mailing address
3409 NW 189TH TER, EDMOND, OK 73012-0022
(405) 473-0281

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7211
OK

Other

Enumeration date
07/12/2019
Last updated
07/12/2019
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