Organization
CANADIAN VALLEY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAY DEAN TATE D.D.S. (DENTIST)
(405) 262-6677
Entity
Organization
Contact information
Practice address
705 EAGLE CIRCLE, EL RENO, OK 73036-2150
(405) 262-6677
(405) 262-1235
Mailing address
705 EAGLE CIRCLE, EL RENO, OK 73036-2150
(405) 262-6677
(405) 262-1235
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
6815
OK
Other
Enumeration date
06/06/2016
Last updated
07/12/2021
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