Organization
HAPPY TOOTH DENTAL GROUP OF SKIATOOK P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONAH R.B. VANDIVER D.D.S. (OWNER)
(918) 396-7766
Entity
Organization
Contact information
Practice address
5265 W ROGERS BLVD STE C, SKIATOOK, OK 74070-5200
(918) 396-7766
(918) 396-7767
Mailing address
5265 W ROGERS BLVD STE C, SKIATOOK, OK 74070-5200
(918) 396-7766
(918) 396-7767
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5392
OK
Other
Enumeration date
09/28/2009
Last updated
09/28/2009
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