Individual
DR. BRANT PHILIP ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
559 MEADOW CREEK DR, TAHLEQUAH, OK 74464-1088
(918) 456-0977
(855) 856-5958
Mailing address
559 MEADOW CREEK DR, TAHLEQUAH, OK 74464-1088
(918) 456-0977
(855) 856-5958
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5706
OK
Other
Enumeration date
08/25/2005
Last updated
07/21/2020
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