Individual
BRAXTON FELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7100 SE 15TH ST, MIDWEST CITY, OK 73110-5234
(405) 241-9960
Mailing address
1001 SHADOW LN, LAS VEGAS, NV 89106-4124
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7917
OK
Other
Enumeration date
05/25/2023
Last updated
08/09/2024
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