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Organization

ANDREA MATLI SCOVILLE DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREA MATLI SCOVILLE DDS (OWNER)
(580) 623-7121
Entity
Organization

Contact information

Practice address
601 W 2ND ST, WATONGA, OK 73772-2601
(580) 623-7121
(580) 623-7124
Mailing address
601 W 2ND ST, WATONGA, OK 73772-2601
(580) 623-7121
(580) 623-7124

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4530
OK

Other

Enumeration date
02/24/2011
Last updated
08/29/2016
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