Organization
WHITWELL DENTISTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN LEE WHITWELL DDS (OWNER)
(405) 842-1115
Entity
Organization
Contact information
Practice address
5103 N SHARTEL AVE, OKLAHOMA CITY, OK 73118-6024
(405) 842-1115
(405) 842-2046
Mailing address
5103 N SHARTEL AVE, OKLAHOMA CITY, OK 73118-6024
(405) 842-1115
(405) 842-2046
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5502
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5502
OK DENTAL LICENSE
OK
Enumeration date
04/29/2008
Last updated
04/29/2008
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