Organization
COMPREHENSIVE DENTAL AND ORAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIDA RADFAR DDS, MS (DIRECTOR)
(405) 348-9911
Entity
Organization
Contact information
Practice address
1713A W 33RD ST, EDMOND, OK 73013-3819
(405) 348-9911
(405) 348-9915
Mailing address
1713A W 33RD ST, EDMOND, OK 73013-3819
(405) 348-9911
(405) 348-9915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5905
OK
1223G0001X
General Practice Dentistry
Primary
5905
OK
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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