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Organization

PEDIATRIC DENTAL ASSOCIATES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EUGENE A LITTEKEN DDS (PRESIDENT)
(580) 226-6290
Entity
Organization

Contact information

Practice address
1103 WALNUT DRIVE, PEDIATRIC DENTAL ASSOCIATES PC, ARDMORE, OK 73401
(580) 226-6290
(580) 223-4381
Mailing address
1103 WALNUT DRIVE, PEDIATRIC DENTAL ASSOCIATES PC, ARDMORE, OK 73401
(580) 226-6290
(580) 223-4381

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100182220C
OK
Enumeration date
12/01/2006
Last updated
06/28/2013
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  • EDI platform