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Individual

RAY W BROADFOOT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2200 NW 122ND ST, OKLAHOMA CITY, OK 73120-8402
(405) 755-4321
(405) 755-7264
Mailing address
2200 NW 122ND ST, OKLAHOMA CITY, OK 73120-8402
(405) 755-4321
(405) 755-7264

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3725
OK

Other

Enumeration date
01/06/2006
Last updated
07/08/2007
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