Individual
TREVOR RACZKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4770 S HARVARD AVE, TULSA, OK 74135-3024
(918) 215-2858
Mailing address
3100 NW 61ST TER, OKLAHOMA CITY, OK 73112-4219
(405) 642-5249
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7877
OK
Other
Enumeration date
05/22/2024
Last updated
05/22/2024
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