| Lone Grove Dentistry & Braces | |
|
16931 Us Highway 70 Lone Grove OK 73443-6523 | |
| (580) 657-3117 | |
| Not Available |
| Full Name | Lone Grove Dentistry & Braces |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 16931 Us Highway 70, Lone Grove, Oklahoma |
| Authorized Official Name and Position | Benjamin James Bowman (OWNER) |
| Authorized Official Contact | 4053755855 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lone Grove Dentistry & Braces 16931 Us Highway 70 Lone Grove OK 73443-6523 Ph: () - | Lone Grove Dentistry & Braces 16931 Us Highway 70 Lone Grove OK 73443-6523 Ph: (580) 657-3117 |
| NPI Number | 1063051795 |
|---|---|
| Provider Enumeration Date | 12/28/2019 |
| Last Update Date | 08/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063051795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Michael D Weaver Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 16931 Us Hwy 70, Lone Grove, OK 73443 Phone: 580-657-3117 Fax: 580-657-8081 |