Organization
SCOT SHADID DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOT SHADID DDS (OWNER)
(405) 275-4581
Entity
Organization
Contact information
Practice address
3 E MACARTHUR ST, SHAWNEE, OK 74804-2141
(405) 275-4581
Mailing address
3 E MACARTHUR ST, SHAWNEE, OK 74804-2141
(405) 275-4581
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4631
OK
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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