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Organization

COFFEE CREEK FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACK T. RUDD DDS (OWNER)
(405) 844-6333
Entity
Organization

Contact information

Practice address
2600 TAYLER ST, EDMOND, OK 73003-2134
(405) 844-6333
(405) 844-6331
Mailing address
2600 TAYLER ST, EDMOND, OK 73003-2134
(405) 844-6333
(405) 844-6331

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
10/10/2018
Last updated
01/20/2021
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