Organization
MUSTANG NORTH DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN BOWMAN (OWNER)
(405) 326-8004
Entity
Organization
Contact information
Practice address
1709 S MUSTANG RD, STE A, YUKON, OK 73099
(405) 862-7007
Mailing address
1709 S MUSTANG RD, STE A, YUKON, OK 73099
(405) 862-7007
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
05/17/2021
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