Individual
SILAS DODGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 W 3RD ST, ELK CITY, OK 73644-5202
(580) 225-7961
Mailing address
412 W 3RD ST, ELK CITY, OK 73644-5202
(580) 225-7961
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15624
OK
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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