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Individual

DR. ROCKY DON CULLENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
425 WEST STONEWOOD DRIVE, BROKEN ARROW, OK 74012
(918) 921-9003
(918) 619-9006
Mailing address
425 WEST STONE WOOD DRIVE, BROKEN ARROW, OK 74012
(918) 921-9003
(918) 615-9006

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
3583
AR
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5601
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
161313679
AR
05
200088490A
OK
05
200660560A
OK
01
5A010
BLUE CROSS BLUE SHIELD
AR
Enumeration date
07/18/2006
Last updated
12/22/2016
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