Individual
MARK ELLIS METTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
839 W COUNTRY CLUB RD, CHICKASHA, OK 73018-7281
(405) 224-7036
Mailing address
839 W COUNTRY CLUB RD, CHICKASHA, OK 73018-7281
(405) 224-7036
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3949
OK
Other
Enumeration date
09/15/2010
Last updated
09/15/2010
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