Organization
TALDG PLLC
Active
Other names
Ft. Gibson Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI WILLIAMS (VP OF GROWTH)
(405) 250-2255
Entity
Organization
Contact information
Practice address
801 S LEE ST STE A, FORT GIBSON, OK 74434-8710
(918) 478-4433
Mailing address
801 S LEE ST STE A, FORT GIBSON, OK 74434-8710
(918) 478-4433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
12/31/2021
Last updated
01/22/2024
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