Organization
VAN-DAO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK R VANDENBERG DDS (OWNER)
(405) 722-7767
Entity
Organization
Contact information
Practice address
12321 HIDDEN FOREST BLVD, OKLAHOMA CITY, OK 73142-2578
(405) 722-7767
(405) 722-8858
Mailing address
12321 HIDDEN FOREST BLVD, OKLAHOMA CITY, OK 73142-2578
(405) 722-7767
(405) 722-8858
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
OK5132
OK
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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