Organization
KINGFISHER DENTAL PLLC
Active
Other names
Kingfisher Dentistry and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN JAMES BOWMAN (OWNER)
(405) 375-5855
Entity
Organization
Contact information
Practice address
100 STARLITE DR, KINGFISHER, OK 73750
(405) 375-5855
(405) 358-2946
Mailing address
9060 HARMONY DR, STE E, MIDWEST CITY, OK 73130
(405) 594-8844
(405) 485-8043
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3767
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200208490A
—
OK
Enumeration date
02/16/2007
Last updated
02/15/2021
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