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Individual

RICHARD FENTEM JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
304 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-4433
(405) 733-0002
(405) 741-2230
Mailing address
304 S AIR DEPOT BLVD, MIDWEST CITY, OK 73110-4433
(405) 733-0002
(405) 741-2230

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4410
OK

Other

Enumeration date
06/23/2006
Last updated
01/14/2014
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