| Mydentist-muskogee | |
|
3201 W Broadway St Muskogee OK 74401-2132 | |
| (918) 686-6684 | |
| Not Available |
| Full Name | Mydentist-muskogee |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3201 W Broadway St, Muskogee, Oklahoma |
| Authorized Official Name and Position | Hannah Fish (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175405699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mydentist-muskogee 3201 W Broadway St Muskogee OK 74401-2132 Ph: () - | Mydentist-muskogee 3201 W Broadway St Muskogee OK 74401-2132 Ph: (918) 686-6684 |
| NPI Number | 1154741023 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154741023 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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