Individual
CALLIE D BOUZIDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
6565 S YALE AVE, SUITE 1100, TULSA, OK 74136-8327
(918) 481-4900
Mailing address
2144 S HUDSON PL, TULSA, OK 74114-2252
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6183
OK
Other
Enumeration date
06/20/2010
Last updated
06/20/2010
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