Individual
DR. SHANNON RENE MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
10914 HEFNER POINTE DR, SUITE 150, OKLAHOMA CITY, OK 73120-5066
(405) 946-5558
Mailing address
10914 HEFNER POINTE DR, SUITE 150, OKLAHOMA CITY, OK 73120-5066
(405) 946-5558
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6212
OK
Other
Enumeration date
07/08/2010
Last updated
11/15/2012
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