Individual
TEVIN RENKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 RANDOLPH ROAD, USA DENTAL HEALTH ACTIVITY, COWAN DC, FORT SILL, OK 73503-5645
(580) 442-5925
Mailing address
605 RANDOLPH RD, FORT SILL, OK 73503-4535
(580) 442-5925
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61863
KS
Other
Enumeration date
06/20/2022
Last updated
08/26/2023
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