Organization
EASY DENTAL SOLUTIONS IV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY LONG (DIRECTOR OF BUSINESS OPERATIONS)
(405) 376-6565
Entity
Organization
Contact information
Practice address
1100 N MUSTANG RD, MUSTANG, OK 73064-7201
(405) 376-6565
(405) 376-2443
Mailing address
10001 S PENNSYLVANIA AVE, SUITE M 220, OKLAHOMA CITY, OK 73159-6923
(405) 796-8012
(405) 378-2381
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
OK
Other
Enumeration date
03/29/2016
Last updated
03/29/2016
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