Organization
CUSTOM DENTAL OF OWASSO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RON CAMPBELL DDS (DENTIST)
(918) 371-7645
Entity
Organization
Contact information
Practice address
11501 N. 135TH EAST AVE, OWASSO, OK 74055
(918) 371-7645
(918) 371-7272
Mailing address
2001 S DIVISION ST, GUTHRIE, OK 73044-6063
(405) 282-6440
(405) 282-6785
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6099
OK
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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