Organization
REDBUD DENTAL MIDWEST CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM C BREWER D.D.S. (OWNER/DENTIST)
(405) 888-5379
Entity
Organization
Contact information
Practice address
101 N DOUGLAS BLVD, STE T, MIDWEST CITY, OK 73130-3329
(405) 888-5379
Mailing address
101 N DOUGLAS BLVD, STE T, MIDWEST CITY, OK 73130-3329
(405) 888-5379
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
1223G0001X
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200199260A
—
OK
Enumeration date
05/25/2015
Last updated
05/25/2015
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