Individual
OLLIE LOGAN BEARD IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
610 E 24TH ST, TISHOMINGO, OK 73460-3245
(580) 371-2343
(580) 371-2451
Mailing address
PO BOX 128, MADILL, OK 73446-0128
(580) 795-6664
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6918
OK
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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