Individual
DR. CASEY GLENN FISHBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2205 CHANDLER RD, MUSKOGEE, OK 74403-4626
(918) 683-2291
(918) 683-2491
Mailing address
2601 HADDOCK DR, MUSKOGEE, OK 74401-2903
(918) 682-5158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4411
KS
Other
Enumeration date
08/11/2005
Last updated
07/08/2007
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