Individual
LYN PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1001 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 421-4570
(580) 421-4595
Mailing address
1001 N COUNTRY CLUB RD, ADA, OK 74820-2847
(580) 421-4570
(580) 421-4595
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5209
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305209
—
OK
Enumeration date
06/21/2007
Last updated
05/16/2008
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