Organization
BRISTOW DENTAL DESIGNS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA HENDRICKSON (DENTIST)
(918) 367-3361
Entity
Organization
Contact information
Practice address
121 N MAIN ST, BRISTOW, OK 74010-2429
(918) 367-3361
Mailing address
PO BOX 867, BRISTOW, OK 74010-0867
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
OK5948
OK
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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