Organization
EASY DENTAL 1
Active
Other names
easy dental 2
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES LYNDSEY GOODWIN DDS (OWNER)
(405) 670-3800
Entity
Organization
Contact information
Practice address
3727 NW 63RD ST, SUITE 112, OKLAHOMA CITY, OK 73116-1931
(405) 842-3700
(405) 842-3708
Mailing address
4341 SE 15TH ST, DEL CITY, OK 73115-3001
(405) 670-3800
(405) 670-3803
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3935
OK
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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