Organization
CROCODILE SMILES CHILDREN'S DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH KELLNER (OWNER)
(405) 636-1616
Entity
Organization
Contact information
Practice address
828 SW 66TH ST, OKLAHOMA CITY, OK 73139-4213
(405) 636-1616
Mailing address
828 SW 66TH ST, OKLAHOMA CITY, OK 73139-4213
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
073
OK
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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