Individual
DR. MARK RANDAL VANDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5801 W BRITTON RD STE B, OKLAHOMA CITY, OK 73132-2404
(405) 722-7767
(405) 722-8858
Mailing address
5801 W BRITTON RD STE B, OKLAHOMA CITY, OK 73132-2404
(405) 722-7767
(405) 722-8858
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5132
OK
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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