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Organization

KINGFISHER DENTAL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN JAMES BOWMAN DDS (OWNER)
(405) 375-5855
Entity
Organization

Contact information

Practice address
2302 FRONTAGE RD, KINGFISHER, OK 73750-4810
(405) 375-5855
(405) 375-5863
Mailing address
2302 FRONTAGE RD, KINGFISHER, OK 73750-4810
(405) 375-5855
(405) 375-5863

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6076
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200208490A
OK
Enumeration date
06/18/2012
Last updated
06/18/2012
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