| Summer Dental Shawnee Pllc | |
|
3703 N Kickapoo Ave Shawnee OK 74804-1703 | |
| (405) 275-0640 | |
| Not Available |
| Full Name | Summer Dental Shawnee Pllc |
|---|---|
| Speciality | Dentist |
| Location | 3703 N Kickapoo Ave, Shawnee, Oklahoma |
| Authorized Official Name and Position | Mike Yates (COO) |
| Authorized Official Contact | 9189980996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summer Dental Shawnee Pllc 400 Riverwalk Ter Ste 250 Jenks OK 74037-5619 Ph: (918) 998-0996 | Summer Dental Shawnee Pllc 3703 N Kickapoo Ave Shawnee OK 74804-1703 Ph: (405) 275-0640 |
| NPI Number | 1548834872 |
|---|---|
| Provider Enumeration Date | 05/20/2021 |
| Last Update Date | 05/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548834872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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