Individual
BRADEN CALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1829 S WOOD DR, OKMULGEE, OK 74447-6825
(918) 756-6500
Mailing address
5810 E SKELLY DR STE 1800, TULSA, OK 74135-6434
(918) 998-0996
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6976
OK
Other
Enumeration date
07/06/2017
Last updated
06/11/2019
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