Organization
CHRIS FAGAN DDS PLLC
Active
Other names
Brush Pediatric & Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRIS P FAGAN DDS, PLLC (GENERAL DENTIST/OWNER)
(580) 233-0043
Entity
Organization
Contact information
Practice address
423 N VAN BUREN ST, ENID, OK 73703-4454
(580) 233-0043
(580) 233-8571
Mailing address
423 N VAN BUREN ST, ENID, OK 73703-4454
(580) 233-0043
(580) 233-8571
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6280
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200047990A
—
OK
Enumeration date
10/26/2006
Last updated
06/30/2016
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