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Contact Information

29TH STREET DENTAL CARE
2900 W GRAND AVE
CHICKASHA, OK73018-5112
 Phone: 405-222-0222
 Fax: 405-222-0210
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for 29TH STREET DENTAL CARE · (Female)

NPI # 1912450842
Status Active
Credentials
Entity Individual
Enumeration date 07/27/2016
Last updated 07/27/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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