Organization
SUMMER DENTAL MIDWEST CITY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CREED L CARDON (CLINICAL DIRECTOR)
(918) 998-0996
Entity
Organization
Contact information
Practice address
1900 S AIR DEPOT BLVD STE 1, MIDWEST CITY, OK 73110-5522
(405) 455-1534
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 988-0996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
08/10/2020
Last updated
09/29/2020
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