Individual
COURTNEY PENDERGRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-2800
Mailing address
4430 HIGHWAY 412, ROSE, OK 74364-1677
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3602
OK
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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