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Edmond Dentistry And Braces

Clinic/Center, Dental in Edmond, OK. Organization (NPI-2).

NPI number1487293270
StatusActive
Last updated in NPPESJun 16, 2021

Details

NPI
1487293270
Entity type
Organization (NPI-2)
Legal business name
Edmond Dentistry And Braces
Organization subpart
No
Enumeration date
Dec 27, 2019
Certification date
Jun 16, 2021
Last updated
Jun 16, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QD0000X Clinic/Center, Dental––Yes

Other names

  • Smileworx Dental (Doing Business As)

Practice location

13912 N Western Ave
Edmond, OK 73013-1792

Phone 405-840-5591

Mailing address

13912 N Western Ave
Edmond, OK 73013-1792

Authorized official

Benjamin James Bowman
Owner
4053268004

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