Organization
FAMILY SMILES DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN DALE CLOTHIER D.D.S. (OWNER)
(918) 251-3333
Entity
Organization
Contact information
Practice address
300 N ASPEN AVE, BROKEN ARROW, OK 74012-2205
(918) 251-3333
Mailing address
16534 E 49TH PL, TULSA, OK 74134-7190
(918) 251-8999
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5817
OK
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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