Individual
DR. RYAN L BRACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1300 CROP CIR, YUKON, OK 73099-4945
(405) 354-4545
(405) 354-4542
Mailing address
1300 CROP CIR, YUKON, OK 73099-4945
(405) 354-4545
(405) 354-4542
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
72
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200018800A
—
OK
Enumeration date
09/24/2006
Last updated
08/17/2009
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