Organization
SHAWNEE DENTISTRY AND BRACES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD NELSON (OWNER)
(405) 260-6080
Entity
Organization
Contact information
Practice address
2616 N PARK AVE, SHAWNEE, OK 74804-2838
(405) 275-7730
Mailing address
2616 N PARK AVE, SHAWNEE, OK 74804-2838
(405) 275-7730
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2018
Last updated
02/05/2024
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