Organization
BLUE RIVER SMILES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA BRASHER DDS (PRESIDENT)
(405) 474-6362
Entity
Organization
Contact information
Practice address
1202 E MAIN ST, TISHOMINGO, OK 73460-2409
(580) 371-2396
Mailing address
3901 E COVELL RD, EDMOND, OK 73034-6909
(405) 359-0808
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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