Organization
CARRIE DS FAMILY DENTISTRY INC
Active
Other names
Riverwalk Dental Spa
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARRIE D SESSOM D.D.S. (OWNER)
(918) 392-7654
Entity
Organization
Contact information
Practice address
400 RIVERWALK TERRACE, SUITE 200, JENKS, OK 74037-5627
(918) 392-7654
(918) 518-5760
Mailing address
400 RIVERWALK TERRACE, SUITE 200, JENKS, OK 74037-5627
(918) 392-7654
(918) 518-5760
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5239
OK
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
02/17/2011
Last updated
09/09/2014
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