Stephen W Garder
Dentist in Moore, OK. Organization (NPI-2).
NPI number1801060751
StatusActive
Last updated in NPPESApr 22, 2008
Details
- NPI
- 1801060751
- Entity type
- Organization (NPI-2)
- Legal business name
- Stephen W Garder
- Organization subpart
- No
- Enumeration date
- Apr 22, 2008
- Last updated
- Apr 22, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 4599 | OK | Yes |
Practice location
808 Ne 19th StMoore, OK 73160-6302
Phone 405-799-5529 · Fax 405-799-8223
Mailing address
808 Ne 19th StMoore, OK 73160-6302
Phone 405-799-5529 · Fax 405-799-8223
Authorized official
Stephen W Garder
Dentist
4057995529
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