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Organization

LEROY PLACE D.D.S., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GWEN PLACE (OFFICE ADMINISTRATOR)
(918) 534-3170
Entity
Organization

Contact information

Practice address
417 E DON TYLER AVE, DEWEY, OK 74029-2315
(918) 534-3170
(918) 534-1522
Mailing address
417 E DON TYLER AVE, DEWEY, OK 74029-2315
(918) 534-3170
(918) 534-1522

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
2719
OK

Other

Enumeration date
05/19/2008
Last updated
05/19/2008
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