Organization
OKC 89TH DENTAL, PLLC
Active
Other names
Summer Dental OKC
Organization subpart
No
Provider details
NPI number
Authorized official
CREED LOUIS CARDON DDS (OWNER)
(918) 998-0996
Entity
Organization
Contact information
Practice address
7801 S WESTERN AVE STE 101, OKLAHOMA CITY, OK 73139-2411
(405) 691-3399
(405) 256-1191
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 998-0996
(918) 235-9079
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200679550A
—
OK
Enumeration date
11/21/2016
Last updated
08/12/2020
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