Individual
THOMAS BLAKE SUDBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
615 N. COMMERCE, ARDMORE, OK 73401
(580) 223-6720
Mailing address
615 N. COMMERCE, ARDMORE, OK 73401
(580) 223-6720
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5443
OK
Other
Enumeration date
09/06/2007
Last updated
09/06/2007
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