Individual
DR. LEE R. CENTRACCO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5400 N GRAND BLVD, STE 150, OKLAHOMA CITY, OK 73112-5692
(405) 946-5198
(405) 946-9378
Mailing address
5400 N GRAND BLVD, STE 150, OKLAHOMA CITY, OK 73112-5692
(405) 946-5198
(405) 946-9378
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5 3716
OK
Other
Enumeration date
08/18/2005
Last updated
07/08/2007
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