Organization
VIAN FAMILY DENTAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN COFFEE DDS (OWNER/DENTIST)
(918) 773-6200
Entity
Organization
Contact information
Practice address
HIGHWAY 82 SOUTH AND I40 JUNCTION, VIAN, OK 74962-0696
(918) 773-6200
(918) 773-6201
Mailing address
PO BOX 696, VIAN, OK 74962-0696
(918) 773-6200
(918) 773-6201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5317
OK
Other
Enumeration date
07/01/2006
Last updated
08/22/2020
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