Organization
DOUGLAS C.CHANCELLOR D.D.S.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS C CHANCELLOR D.D.S. (OWNER)
(405) 348-5254
Entity
Organization
Contact information
Practice address
4440 NW EXPRESSWAY, SUITE A, OKLAHOMA CITY, OK 73116-1533
(405) 848-4442
Mailing address
2603 PAWNEE XING, EDMOND, OK 73034-6882
(405) 348-5254
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
4404
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100117130
—
OK
Enumeration date
01/24/2008
Last updated
03/28/2013
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