Organization
MCALESTER CHILDREN'S DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANNA CHERYL MCINTOSH DDS (PRESIDENT)
(918) 423-2897
Entity
Organization
Contact information
Practice address
329 W CARL ALBERT PKWY, MCALESTER, OK 74501-4418
(918) 423-2897
Mailing address
329 W CARL ALBERT PKWY, MCALESTER, OK 74501-4418
(918) 423-2897
(918) 423-0905
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5023
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100119570
—
OK
Enumeration date
09/19/2011
Last updated
09/19/2011
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