Organization
CHAD D SPIVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD D SPIVA DDS (OWNER)
(405) 799-5529
Entity
Organization
Contact information
Practice address
808 NE 19TH ST, MOORE, OK 73160-6302
(405) 799-5529
(405) 799-8223
Mailing address
808 NE 19TH ST, MOORE, OK 73160-6302
(405) 799-5529
(405) 799-8223
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5497
OK
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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