Individual
DR. BOBBY DON CHEATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2800 NORTH KELLY AVENUE, 200, EDMOND, OK 73003-3004
(405) 562-2222
(405) 562-2200
Mailing address
4205 CHERRY HILL LANE, OKLAHOMA CITY, OK 73120-8105
(405) 755-9837
(405) 752-2091
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
422062SPECIALTY
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100123080A
—
OK
05
—
100123080D
—
OK
Enumeration date
09/14/2006
Last updated
07/08/2007
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