Individual
LOREN PAUL ISRAELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2616 N PARK AVE, SHAWNEE, OK 74804-2838
(405) 275-7730
Mailing address
2616 N PARK AVE, SHAWNEE, OK 74804-2838
(405) 275-7730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7090
OK
Other
Enumeration date
06/28/2018
Last updated
02/05/2024
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