| Prague Dentistry Pllc | |
|
710 N Jim Thorpe Blvd Prague OK 74864-4527 | |
| (405) 930-4100 | |
| Not Available |
| Full Name | Prague Dentistry Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 710 N Jim Thorpe Blvd, Prague, Oklahoma |
| Authorized Official Name and Position | Benjamin Bowman (CEO) |
| Authorized Official Contact | 4053268004 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prague Dentistry Pllc 851 W I 35 Frontage Rd Ste 350 Edmond OK 73034-7472 Ph: (405) 930-4100 | Prague Dentistry Pllc 710 N Jim Thorpe Blvd Prague OK 74864-4527 Ph: (405) 930-4100 |
| NPI Number | 1710722392 |
|---|---|
| Provider Enumeration Date | 06/26/2024 |
| Last Update Date | 06/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710722392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |