Individual
DR. STACY LYNN REVELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
720 W GRAND AVE, CHICKASHA, OK 73018-5743
(405) 224-1311
(405) 222-3654
Mailing address
720 W GRAND AVE, CHICKASHA, OK 73018-5743
(405) 224-1311
(405) 222-3654
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5709
OK
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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