Individual
IVY S SPARLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1216 E HARTFORD AVE STE 1A, PONCA CITY, OK 74601-2059
(580) 762-9119
Mailing address
304 LONNIE AVE, PONCA CITY, OK 74601-1310
(620) 446-2267
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7932
OK
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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