Organization
CUSTOM DENTAL OF NEWCASTLE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENE RODGERS (CHIEF OPERATING OFFICER)
(405) 282-6440
Entity
Organization
Contact information
Practice address
3290 N TRI-CITY, NEWCASTLE, OK 73065
(405) 657-0038
Mailing address
3290 N TRI-CITY, NEWCASTLE, OK 73065
(405) 657-0038
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6098
OR
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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