Individual
BEAU E SPARKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
104 W RAY FINE BLVD, STE. 5, ROLAND, OK 74954-5289
(918) 503-6262
(918) 913-4595
Mailing address
104 W RAY FINE BLVD, STE. 5, ROLAND, OK 74954-5289
(918) 503-6262
(918) 913-4595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3833
AR
1223G0001X
General Practice Dentistry
Primary
6347
OK
Other
Enumeration date
06/28/2011
Last updated
02/03/2016
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