Casey A Roberts DDS PC
Dentist, General Practice in Durant, OK. Organization (NPI-2).
NPI number1760664015
StatusActive
Last updated in NPPESFeb 24, 2017
Details
- NPI
- 1760664015
- Entity type
- Organization (NPI-2)
- Legal business name
- Casey A Roberts DDS PC
- Organization subpart
- No
- Enumeration date
- Nov 28, 2007
- Last updated
- Feb 24, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 5808 | OK | Yes |
Other names
- Magnolia City Dental (Doing Business As)
Practice location
2425 W. University Blvd.Ste. 102
Durant, OK 74701
Phone 580-924-3330 · Fax 580-924-3339
Mailing address
2425 W. University Blvd.Ste. 102
Durant, OK 74701
Phone 580-924-3330 · Fax 580-924-3339
Authorized official
Casey A Roberts
Owner/Dentist
5809243330
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