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Organization

LAWTON ENDODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAY SCOTT SULLINS D.D.S. (PRESIDENT)
(580) 248-3636
Entity
Organization

Contact information

Practice address
8504 NW CACHE RD, LAWTON, OK 73505-9604
(580) 248-3636
(580) 248-3533
Mailing address
8504 NW CACHE RD, LAWTON, OK 73505-9604
(580) 248-3636
(580) 248-3533

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
38
OK

Other

Enumeration date
06/21/2011
Last updated
06/21/2011
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