Organization
BLUE AND RED DENTAL LLC
Active
Other names
Shine Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN DALE PATTEN D.D.S. (DENTIST)
(918) 518-6305
Entity
Organization
Contact information
Practice address
2840 E 101ST ST, TULSA, OK 74137-5601
(918) 518-6305
(918) 518-6327
Mailing address
2840 E 101ST ST, TULSA, OK 74137-5601
(918) 518-6305
(918) 518-6327
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
5990
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200119910A
—
OK
Enumeration date
02/23/2012
Last updated
02/23/2012
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