Organization
HAPPY TOOTH DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONAH R.B. VANDIVER D.D.S. (OWNER/DENTIST)
(918) 341-6900
Entity
Organization
Contact information
Practice address
900 E WILL ROGERS BLVD STE A, CLAREMORE, OK 74017-6303
(918) 341-6900
(918) 341-6910
Mailing address
900 E WILL ROGERS BLVD STE A, CLAREMORE, OK 74017-6303
(918) 341-6900
(918) 341-6910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5392
OK
Other
Enumeration date
03/10/2008
Last updated
04/16/2008
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