Organization
ABSOLUTE SMILES FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN G. CHASTAIN DDS (OWNER)
(405) 381-0900
Entity
Organization
Contact information
Practice address
4800 E. HWY. 37, TUTTLE, OK 73089
(405) 381-0900
(405) 381-0902
Mailing address
4800 E. HWY. 37, TUTTLE, OK 73089
(405) 381-0900
(405) 381-0902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5944
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200115890A
—
OK
Enumeration date
10/28/2010
Last updated
10/28/2010
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