| Custom Dental Of Cushing,pllc | |
|
3200 E. Main Street Cushing OK 74023 | |
| (405) 343-2737 | |
| Not Available |
| Full Name | Custom Dental Of Cushing,pllc |
|---|---|
| Speciality | Dentist |
| Location | 3200 E. Main Street, Cushing, Oklahoma |
| Authorized Official Name and Position | Dan Messer (DENTIST) |
| Authorized Official Contact | 4053432737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Dental Of Cushing,pllc 3200 E. Main Street Cushing OK 74023 Ph: (405) 343-2737 | Custom Dental Of Cushing,pllc 3200 E. Main Street Cushing OK 74023 Ph: (405) 343-2737 |
| NPI Number | 1609140755 |
|---|---|
| Provider Enumeration Date | 03/06/2012 |
| Last Update Date | 03/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609140755 | NPI | - | NPPES |
| 200346500A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5997 (Oklahoma) | Primary |
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