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Organization

PROUD DENTAL, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NATHAN NICHOLAS PROUD D.D.S. (DR/OWNER)
(405) 282-2530
Entity
Organization

Contact information

Practice address
324 N 19TH ST, SUITE 2, GUTHRIE, OK 73044-2117
(405) 282-2530
(405) 282-2537
Mailing address
324 N. 19 ST., SUITE 2, GUTHRIE, OK 73044
(405) 282-2530
(405) 282-2537

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6152
OK

Other

Enumeration date
08/03/2012
Last updated
08/03/2012
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