Organization
WAGONER FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL K CRAIG D.D.S. (OWNER)
(918) 485-2200
Entity
Organization
Contact information
Practice address
900 E CHEROKEE ST, WAGONER, OK 74467-4718
(918) 485-2200
(918) 485-8877
Mailing address
900 E CHEROKEE ST, WAGONER, OK 74467-4718
(918) 485-2200
(918) 485-8877
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5069
OK
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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