Individual
TIERENY WITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
RR 1 BOX 3060, CLINTON, OK 73601-9303
(580) 331-3426
Mailing address
PO BOX 82, FOSS, OK 73647-0082
(580) 819-0399
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3308
OK
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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