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Organization

SHANKLE DENTAL-BROKEN ARROW PLLC

Active
Other names
Dentistry for You
Organization subpart
No

Provider details

NPI number
Authorized official
RON FERNANDEZ (CEO)
(918) 960-3070
Entity
Organization

Contact information

Practice address
2522 E KENOSHA ST., BROKEN ARROW, OK 74014-6712
(918) 355-1391
(918) 355-4135
Mailing address
5314 S YALE AVE., SUITE 400, TULSA, OK 74135
(918) 960-3070

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
12/04/2018
Last updated
06/20/2024
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