Organization
MOBILE DENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYAN LAWSON D.M.D. (PRESIDENT)
(918) 706-5584
Entity
Organization
Contact information
Practice address
615 E 17TH ST, STROUD, OK 74079-5316
(918) 706-5584
Mailing address
615 E 17TH ST, STROUD, OK 74079-5316
(918) 706-5584
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5809
OK
Other
Enumeration date
12/19/2006
Last updated
08/22/2020
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