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Organization

WEATHERFORD DENTAL CARE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NATHAN CLARK VILLINES DDS (DENTIST)
(580) 772-2471
Entity
Organization

Contact information

Practice address
1325 N. WASHINGTON STREET, WEATHERFORD, OK 73096
(580) 772-2471
(580) 772-2436
Mailing address
1325 N. WASHINGTON STREET, WEATHERFORD, OK 73096
(580) 772-2471
(580) 772-2436

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5446
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100126540A
OK
Enumeration date
08/27/2012
Last updated
08/27/2012
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