Organization
59TH STREET DENTAL HEALTH CENTER, P.C.
Active
Other names
ABC Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS BOYER (OWNER)
(405) 631-2700
Entity
Organization
Contact information
Practice address
309 SW 59TH ST STE 105, OKLAHOMA CITY, OK 73109-8322
(405) 631-2700
Mailing address
309 SW 59TH ST STE 105, OKLAHOMA CITY, OK 73109-8322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6574
OK
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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