Organization
MAGNOLIA DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD BLACKBURN DDS (DDS/OWNER)
(918) 774-5457
Entity
Organization
Contact information
Practice address
3100 NW 150TH ST, SUITE 100, OKLAHOMA CITY, OK 73134
(405) 283-8158
Mailing address
8509 NW 109TH ST, OKLAHOMA CITY, OK 73162-3020
(918) 774-5457
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2025
Last updated
06/05/2025
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