Individual
DR. TIM R FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1201 N STONEWALL AVE, OKLAHOMA CITY, OK 73117-1214
(405) 271-5444
Mailing address
423 N VAN BUREN ST, ENID, OK 73703-4454
(580) 233-0043
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4227
OK
Other
Enumeration date
06/08/2005
Last updated
07/24/2019
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