Organization
29TH STREET DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C PHILLIPS III D.D.S. (OWNER)
(405) 222-0222
Entity
Organization
Contact information
Practice address
2900 W GRAND AVE, CHICKASHA, OK 73018-5112
(405) 222-0222
(405) 222-0210
Mailing address
2900 W GRAND AVE, CHICKASHA, OK 73018-5112
(405) 222-0222
(405) 222-0210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/27/2016
Last updated
07/27/2016
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